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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1443389



Case Details

VAERS ID: 1443389 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-28
Onset:2021-06-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling of body temperature change, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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: morphine sulfate 15MG 4 per day, 10/325 6 per day.
Current Illness:
Preexisting Conditions: chronic pain, nerves damage.
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Major tired, then I got super cold. I had uncontrollable shacking for about two hours or more (sometimes it felt like a seizure. . This started about 6PM Tuesday night. By 7AM I went from cold to hot/fever. I finally felt like the fever broke around 8PM Wednesday Night.


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