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

This is VAERS ID 1474828



Case Details

VAERS ID: 1474828 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Musculoskeletal chest pain
SMQs:

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported to EMTs pain on her left side around her ribs that she described as "pulsating." Vitals obtained at 2:08PM were as follows: BP 130/76, HR 75, and O2 98%. The client denied any SOB, chest pressure, or throat tightness. The client reports a history of a similar pain on her left side of unknown origin. The client was alert and oriented to person, place, time, and events. The client rated the pain at a 3-4 on a scale of 10. The client has a history of hypertension, which is controlled with Lisinopril. Repeat vitals obtained at 2:20PM were as follows: BP 138/76, HR 67, and O2 98%. The client stated, "I''m okay I can walk." The client stated her symptoms were unchanged. The client elected to leave the vaccination site. Client ambulated away from the observation area unassisted with a steady gait at 2:23PM.


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