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From the 11/19/2021 release of VAERS data:

This is VAERS ID 907385

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Case Details

VAERS ID: 907385 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kentucky  
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 025JZOA / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Heart rate irregular, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
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: Initial c/o Lightheadedness within 15 min. of vaccine. Episodes of tachycardia 70''s - 140''s B/P 126/90 Patient monitored & revitaled 1620 B/P 120/72 HR IRREgular 1635 BP 120/72 HR Regular 1645 MD ON SCENE to ASSESS 1655 exited w/husbanD


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