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From the 10/15/2021 release of VAERS data:

This is VAERS ID 906836



Case Details

VAERS ID: 906836 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Cough, Headache, Muscle tightness, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, deep harsh dry cough, HA, burning and tightness across shoulder blades. Arm very sore the next morning


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=906836

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