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

This is VAERS ID 1446299



Case Details

VAERS ID: 1446299 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-15
Onset:2021-06-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Rash papular, Rash pruritic, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: None
Current Illness: Eczema
Preexisting Conditions: Eczema
Allergies: Iodine, penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy raised hives, rash started on right hand and arm, hives on both inner thighs,extremely itchy, then also started on left hand and arm, scratchy throat . Treated with Benedry every 4 hrs., hydrocortisone cream 2.5 percent


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1446299


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