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

This is VAERS ID 910822

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Case Details

VAERS ID: 910822 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Enlarged uvula, Hypersensitivity, Lip oedema, Lip swelling, Nasal congestion, Oedema mouth, Palatal oedema, Paraesthesia oral, Sneezing, Throat tightness, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPINE, HYDROCHLOROTHIAZIDE, CAMRESE, ICAR-C, LEXAPRO, ACZONE, RETIN A MICRO PUMP
Current Illness: NONE
Preexisting Conditions: ANEMIA
Allergies: NORCO, SPIRONOLACTONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: SNEEZING, STUFFY NOSE, LIP SWELLING, TINGLING MOUTH, THROAT CLOSING, UVULA SWOLLEN 1. Allergic reaction (Allergy, unspecified, initial encounter) . Pt. received Moderna COVID vaccine the morning of 12/22/20 and developed angioedema reaction the afternoon of 12/23 Vaccine is only new medication reported by pt. - denies any new products, foods, etc History of hives with spironolactone 2.5 months ago; taking HCTZ now - unknown if reaction is related to this med rather than vaccine? Due to severity of her reaction and uncertainty if all attributable to vaccine versus some other culprit I would recommend Epi pen at time of discharge Has received IM epinephrine, racemic epi neb, Solu-Medrol, Benadryl, Pepcid in the ED Continue with Benadryl 25mg IV q6h, Pepcid 20mg IV q12h, and Solu-Medrol 40mg IV q6h 2. Angioedema (Angioneurotic edema, initial encounter) . Arrived to the ED with R. side lip, tongue, and uvula and oral cavity edema Airway patent, room air O2 sats WNL - monitor throughout the night for any worsening of angioedema or airway involvement Treatment as above


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