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

This is VAERS ID 907481

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Case Details

VAERS ID: 907481 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cold sweat, Flushing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Became flush and clammy 2-3 times. Recovered after 30 minutes of observation


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