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

This is VAERS ID 1437436



Case Details

VAERS ID: 1437436 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-23
Onset:2021-06-29
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: emphysema
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with positive COVID 19 test after vaccination series complete (breakthrough). ASYMPTOMATIC, prescreening test prior to medical appointments


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437436


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