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

This is VAERS ID 1750516

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Case Details

VAERS ID: 1750516 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-30
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Oropharyngeal pain, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Lisinopril, multivitamin, flaxseed oil, Vitamin D3, Calcium-Magnesium-Zinc, Vitamin C
Current Illness: None
Preexisting Conditions: Mild high blood pressure controlled with Lisinopril.
Allergies: Sulpha drugs and Tetanus, apples
Diagnostic Lab Data: Haven''t had time to consult physician yet.
CDC Split Type:

Write-up: Abdominal pains with light bleeding from the vagina. Sore throat on Wednesday afternoon, 9/29/2021, abdominal pains all day on Thursday 9/30/2021, had light bleeding from vagina after getting home from work. Haven''t had a menstruation in about 8 years.


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