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

This is VAERS ID 906572

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Case Details

VAERS ID: 906572 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01120A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Synthroid 88mcg one daily Multivitamin one at night
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: Penicillin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: headache - pt reports she will take Tylenol , reports head is ongoing tingling between shoulders - resolved


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=906572


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