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

This is VAERS ID 1469928



Case Details

VAERS ID: 1469928 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Nervousness, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Additional Details: projectile vomiting, we gave him water helped him clean himself... he stated after the incident that he was super nervous, he gets like this with vaccine


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1469928


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