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

This is VAERS ID 1777819

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Case Details

VAERS ID: 1777819 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-09
Onset:2021-10-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Arthralgia, Chills, Extra dose administered, Fatigue, Hyperhidrosis, Infection, Injection site erythema, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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: 3/06/21 Moderna 2nd shot
Other Medications: Dexilant 60mg,Simvastatin 40mg, Telmastartin, estrogen, progesterone,100, Welbutrin 100
Current Illness: none
Preexisting Conditions: none
Allergies: Bactrum/sulpher
Diagnostic Lab Data: none
CDC Split Type:

Write-up: injection given at 9:30am 10/09/21. Adverse reaction started at 4pm same day. Chills alternating with sweats, low grade fever, extreme pain in joints and muscles all over body, extreme fatigue. Symptoms subsided next day Sunday 9pm. Symptoms returned Monday approx 10am as well as extreme swelling and redness at injection site and down my arm approx 6inches. Saw my general physician. He decided to treat as an infection. Medication prescribed:Cephalexin 500mg. At this time, only 2 doses of medication have been taken. No change yet.


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