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

This is VAERS ID 1470449

Case Details

VAERS ID: 1470449 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood cholesterol increased, Chills, Cough, Dehydration, Dizziness, Dyspnoea, Fatigue, Glucose tolerance impaired, Hypertension, Muscle spasms, Oropharyngeal pain, Pain, Pollakiuria, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad), Hypersensitivity (broad), Dehydration (narrow)

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: Ibuprofen, B12, Magnesium, Potassium, Biotin.
Current Illness:
Preexisting Conditions: Chronic regional pain syndrome, anxiety.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Runny nose, fatigue, muscle spasms, hypertension, pre-diabetes, high cholesterol, body aches, shortness of breath, dizziness, frequent urination, constant coughing, dehydration, sneezing, throat pain, and chills.

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