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

This is VAERS ID 1447036



Case Details

VAERS ID: 1447036 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Mouth swelling, Oral herpes
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal infections (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Patient presented with angioedema. He stated the day after his second shot, he had what appeared to be 2 cold sores, one on each corner of his mouth. He says each day the swelling has gotten worse. (Presenting from vaccine almost 6 weeks ago) He was advised to seek medical advice, to which he declined. He was then advised that if he would not do that, he should take benadryl and ibuprofen.


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