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

This is VAERS ID 1468360



Case Details

VAERS ID: 1468360 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-06
Onset:2021-07-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling, Injection site warmth, Skin texture abnormal
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: Tylenol 500mg, Naprosyn off and on, multi vitamin gummy, vitamin C gummy.
Current Illness: None
Preexisting Conditions: Bipolar, skin cancer from moles, past recreational drug and persctiption abuse with over ten years off them, Marijuana use daily, former cigarette smoker.
Allergies: Latex and natural rubber products, grass, lilacs, cypress, malt.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, swelling, itching, warm to touch, raised and textured injection site seven days after injection.


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