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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1577874

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Case Details

VAERS ID: 1577874 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Rizatriptian Antacids
Current Illness: None
Preexisting Conditions: Migraines Underactive thyroid
Allergies: Sulfa
Diagnostic Lab Data: No e
CDC Split Type:

Write-up: 101.5 fever started at 3am for 24 hours. Also severe body aches and flu like symptoms.


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