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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1510721



Case Details

VAERS ID: 1510721 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-06-22
Onset:2021-06-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Alopecia, Blood urine present
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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: None
Current Illness: I got Covid a month before I got vaccinated.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: side effects of blood in urine and hair loss


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1510721

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