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From the 10/8/2021 release of VAERS data:

This is VAERS ID 908783



Case Details

VAERS ID: 908783 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Vermont  
Vaccinated:2020-12-23
Onset:2020-12-24
   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 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: bumps on wrists with loss of hair, itchiness


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908783

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