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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1437417



Case Details

VAERS ID: 1437417 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-29
Onset:2021-06-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Gait disturbance, Headache, Joint range of motion decreased, Myalgia, Nausea, Pyrexia, Retching
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Furosemide, Lexapro, Albuterol, Metformin, Lisinopril, Amlodipine, Triamcinolone
Current Illness: none
Preexisting Conditions: Diabetes Mellitus type II, Anxiety, Hypertension
Allergies: Crestor, Hctz, Td toxoid, Talwin, Sulfa, Penicillins, Novocain, Norgesic Forte, Codeine
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: Patient experienced chills and fever for hours, Nausea with dry heaves, Diarrhea, severe Headache, Dizziness , staggering gait, myalgia causing difficulty in raising her or moving left arm---patient advised that she could treat signs and symptoms, which started 11pm the night before and continued at time of her call to the office to report adverse reactions at 10 am on 6/30/21


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437417


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