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

This is VAERS ID 1474444



Case Details

VAERS ID: 1474444 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-26
Onset:2021-07-15
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bronchitis, Chest X-ray normal, Chest pain, Condition aggravated, Dyspnoea, Fatigue, Headache, Injection site mass, Muscle spasms, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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: Zyrtec, De3 Dry Eye Omega Supplements with Vitamin D, Echinacea
Current Illness: Sinusitis
Preexisting Conditions: Sinusitis Migraines Low Vitamin D Intermittent Shortness of Breath
Allergies: none Seasonal allergies
Diagnostic Lab Data: Chest Xray on 02/22/21. - Normal
CDC Split Type:

Write-up: The night of the vaccination, i developed a headache and my arm was very sore. By the next morning, my left arm was very painful and I developed a large lump, almost the size of a golf ball at the injection site. I started to feel fatigue and bronchitis coming on. By day 3, extreme fatigue, shortness of breath, headache, painful left arm. Regular albuterol inhaler was not helping at all. I made an appointment with my Dr because I was afraid of getting the second dose of the vaccine if it would make my symptoms worse. I was prescribed a stronger inhaler, which helps a bit, but still have shortness of breath and fatigue. The painful lump in my arm shrunk in size very slowly and is now (6 months later) about the size of a pea. It hurts now only if I touch or bump it. I have since developed occasional pain/cramps in my legs, chest, torso which had me worried about blood clots at first.


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