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

This is VAERS ID 908641

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Case Details

VAERS ID: 908641 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-21
Onset:2020-12-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Eye swelling, Injection site erythema, Injection site swelling, Ocular hyperaemia, Sleep disorder
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: minimal aches with flu vaccine
Other Medications: Edarbyclor 40mg/25mg daily adracet , vitamin D 15mcg, vitamin B complex
Current Illness: no
Preexisting Conditions: healthy
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 24 hours after the vaccine, arm became red and swollen at the injection site. Eyes became red and swollen. Experienced coughing if laying flat, had to sleep upright. Symptoms resolved around 12 hours later.


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