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

This is VAERS ID 1463634



Case Details

VAERS ID: 1463634 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Dizziness, Headache, Hypotension, Malaise, Nausea, Oropharyngeal pain, Pain, Rhinorrhoea, Vertigo
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Dehydration (broad), Hypokalaemia (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: I was taking an antibiotic for bacterial vaginosis and previous to that I took antibiotic for a bladder infection. I was not taking vitamins
Current Illness: I was just passing some bladder stones and was given antibiotic and than the week I got the vaccine I was taking the other antibiotic for bacteria vaginosis. I took the antibiotic that morning and had the vaccine at 2 pm but than I didn?t want to continue with antibiotic
Preexisting Conditions: No
Allergies: No I am not allergic to any medication
Diagnostic Lab Data: No I didn?t go to see a dr.
CDC Split Type:

Write-up: The following day in the morning, I felt weak and my blood pressure was low, than same day I felt nauseated and felt like my head was spinning inside. It was like that all day. 2nd day I felt nauseated and also my head was like spinning inside and than had a very terrible headache later in the day &I was not hungry. I was just in bed. 3rd day, all my body felt sick, had mild running nose, mild cough, mild soar throat and just felt ache, I felt like that all day and till the 4th day. I started feeling myself in the evening of the 4th day. 5 th & 6th day, I just felt on and of light headed and nauseated. It was the most miserable days I?ve had.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1463634


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