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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1696959



Case Details

VAERS ID: 1696959 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Peripheral swelling, Pyrexia, Swelling face, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: patient states went to ER but wait was outrageous, went to urgent care this morning but their system was down. Her pcp could not see her until Thursday. I advised to either go back to ER or another urgent care.
CDC Split Type:

Write-up: The night (Thurs) the vaccine was administered pt reports fever and chills. The following 2 days (Friday & Saturday) the patient reports itching. She reports starting benadryl capsules 2 caps every 6-8hours. By Sunday she reports welts and swollen hands, feet, and face.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1696959

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