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

This is VAERS ID 1759003

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Case Details

VAERS ID: 1759003 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Feeding disorder, Feeling cold, Headache, Illness, Lymphadenopathy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: Shingles, flu vaccine and every covid vaccine
Other Medications: Methotrexate, Celebrex, folic acid, hydrochlorothiazide, atorvastatin, multi-vitamin, vitamin D, Calcium
Current Illness:
Preexisting Conditions: Rheumatoid arthritis
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received the first shot March 6, 2021. I was sick the whole next day. I received my second shot on April 3, 2021. I was sick for 3 days after that one. I had swollen glands that lasted for 2-3 weeks. I got my third shot on September 29, 2021 and I was sick for just over 3 days. I had severe muscle aches starting in early morning after the shot that lasted about 2 days. I had swollen glands on the collarbone on the injection side. I had chills , fevers and weakness for almost 4 days during that time I slept in my winter coat under my bedcovers. When I got out of bed I felt dizzy. I couldn?t eat for the first 3 days. I had severe headaches for the first 2 days after the shot.


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