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

This is VAERS ID 908633

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Case Details

VAERS ID: 908633 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Vermont  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Limb discomfort, Pharyngeal paraesthesia, Productive cough, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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:
Diagnostic Lab Data: ED evaluation developed rash and throat got phlemy
CDC Split Type:

Write-up: flush on legs and arms, transient throat tingles that resolved. Arms heavy


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908633


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