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

This is VAERS ID 918552

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Case Details

VAERS ID: 918552 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 5 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Influenza virus test negative, Nausea, Pyrexia, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Lupus
Preexisting Conditions: Lupus
Allergies: NKA
Diagnostic Lab Data: Pt was tested for Influenza and COVID and lab work was normal
CDC Split Type:

Write-up: Severe diarrhea, cold chills, 101 fever, and nausea


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