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

This is VAERS ID 1483938



Case Details

VAERS ID: 1483938 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-07-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pantoprazole, allopurinol, norethindrone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Two ER visits 7/14 and 7/17 Saw primary 7/12 treated as allergic reaction. Rash will not go away. Will see more doctors next week.
CDC Split Type:

Write-up: Rash at site. Rash progressed all over body over the course of the next few weeks. Treated twice at the ER for allergic reaction. Nothing is helping.


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