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

This is VAERS ID 908662

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Case Details

VAERS ID: 908662 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
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 011J2OA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia, Flushing
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Hypersensitivity (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: pristiq, crestor, lyrica, zyrtec, desmopressin, bystolic
Current Illness: none
Preexisting Conditions: arrythmias, high cholesterol,
Allergies: penicillin, gentamicin,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt was seated and suddenly became flushed and reported a strange taste in her mouth. Vitals taken. BP 116/65, pulse 87, O2 99%. Pt given water and continued to observe. Pt reported feeling better.


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