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

This is VAERS ID 908647

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Case Details

VAERS ID: 908647 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2020-12-22
Onset:2020-12-23
   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: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin 25mcg, Vit D 10,000 iu, Zyrtec 10 mg.
Current Illness:
Preexisting Conditions: Hashimoto?s
Allergies: Erythromycin, penicillin, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt(I) report swelling, redness, and warmth at the injection site was first noticed in the morning at 6:30 am on 12/24/2020 currently 2.5 inches by 1 5/8 inches. Pt has history of hives. Hive type rash noted on inside of right arm. Hive do not itch.


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