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

This is VAERS ID 1467314



Case Details

VAERS ID: 1467314 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenza
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: cipro,dilaudid,morphine,oxycodone,oxycontin,penicillin,percocet,rocephin,sulfa,tylenol-codeine. prior history of reaction to flu vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt presented red itchy rash from face down to legs, pt took 50 mg of benadryl prior to coming to clinic. pt was given in clinic 125 mg solu-medrol and 20 mg of pepcid, symptoms resolved pt sent home


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1467314


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