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From the 12/10/2021 release of VAERS data:

This is VAERS ID 1592542

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Case Details

VAERS ID: 1592542 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast feeding, Chest pain, Dizziness, Headache, Hypoaesthesia, Hypoaesthesia oral, Influenza like illness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Sexual dysfunction (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: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: I did not have any tests done but my daughter tested negative for any respiratory illnesses.
CDC Split Type:

Write-up: Within 10 minutes of receiving the vaccine, I felt that I was going to pass out. I had to sit down on the floor in pharmacy. Within the next few hours, I experienced mild chest pain , mild to moderate head ache, and flu like symptoms. In addition, most of the left side of my face went numb like Bell?s palsy (forehead, cheek, lips and tongue on the left). I got the vaccine on a Tuesday. On Wednesday and Thursday my 10 month old breastfed baby started experiencing hives on her face and body. Her ears were red on the tips. Her hands and fingers were red and swollen hot to the touch. I took her to urgent care where she got an oral steroid. She tested negative for any respiratory virus. It is now a few weeks later and I still have a spot on the left side of my lips with no feeling. I am experiencing extreme fatigue where it is difficult to stay awake throughout the whole day.


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