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From the 1/14/2022 release of VAERS data:

This is VAERS ID 908125

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Case Details

VAERS ID: 908125 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
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 02SJ20-2A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Electrocardiogram normal, Heart rate increased, Paraesthesia oral
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: S/P gastric bypass
Allergies: Denies
Diagnostic Lab Data: EKG; normal, rate 81, no arrythmias, normal intervals Glucose 105 500ml NS Bolus Observed and discharged without further issue
CDC Split Type:

Write-up: 30 mins after vaccination Felt rapid heart rate, tingling in lips, initial BP 100/60


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