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

This is VAERS ID 907016

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Case Details

VAERS ID: 907016 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Iowa  
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 025J20-20 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Dizziness, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of "racing heart beat, dizziness" BP noted 141/92 P104 oxygen 99 repeat temp 97.6 BP 145/89 P96 repeat BP 145/95 Pulse 104 taken to ER for further evaluation and treatment. Temperature rose to 101 while in ER. Patient reports symptoms resolved approximately 1 1/2 hours after injection "feels fine" now Discharged home steady gait.


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