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

This is VAERS ID 1764862

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Case Details

VAERS ID: 1764862 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphoedema
SMQs:, Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: COVID-19 Moderna, Second Dose -fever, chills, aches, resolved after one day.
Other Medications: Letrozole, escitalopram, vitamin B complex, folic acid, diclofenac potassium, magnesium and calcium supplement, Centrum Silver one-a-day.
Current Illness: None
Preexisting Conditions: No spleen, hemochromatosis, breast cancer ("cured")
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lymphedema under the left arm - worst on day 2, and slowly resolving at day 6.


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