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

This is VAERS ID 906418

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Case Details

VAERS ID: 906418 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Alabama  
Vaccinated:2020-12-21
Onset:2020-12-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O11J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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:
Other Medications: Cozaar 25mg by mouth daily. Vitamin D3 2,000 units by mouth daily.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin allergy- break out in rash Codeine allergy- break out in rash
Diagnostic Lab Data: Rapid Covid-19 test done on 12/22/20. Results were Negative.
CDC Split Type:

Write-up: Headache Fever- temp as high as 102.7


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