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

This is VAERS ID 907528

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Case Details

VAERS ID: 907528 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
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 UN / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest X-ray, Full blood count, Metabolic function test, Pruritus, Troponin I
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: IV dye, codiene
Diagnostic Lab Data: CBC, CMP, Troponin I, chest xray
CDC Split Type:

Write-up: History to allergic to IVP dye, after the covid vaccine and said felt itchy in face. Patient given dexamethasone 10 mg diphenhydramine 50mg ,epinephrine 0.5 mg and lactated ringers. Patient issue resolved and will be discharged home.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907528


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