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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1688861

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Case Details

VAERS ID: 1688861 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Arthralgia, Breast pain, Chills, Diarrhoea, Fatigue, Nausea, Pain in extremity, Pain of skin
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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: Labetalol 100mg PO BID HCTZ 12.5mg PO once daily
Current Illness: none
Preexisting Conditions: High blood pressure from Gestational Hypertension that never resolved after the birth of my two sons.
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Right upper arm pain; nausea; bloating, diarrhea; right breast pain; joint pain in hips, knees and ankle; skin is sore to the touch all over body; chills; extreme fatigue


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