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

This is VAERS ID 919320

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Case Details

VAERS ID: 919320 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Dizziness, Hyperhidrosis, Immediate post-injection reaction, Peripheral swelling, SARS-CoV-2 test
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Toperol (high blood pressure) Adderall - 20mg Calcitrol- .5mcg Soduim bycar-650mg
Current Illness: Stage 5 Kidney failure
Preexisting Conditions: Stage 5 Kidney failure
Allergies: Mushrooms Bactriun
Diagnostic Lab Data: Blood test, covid test
CDC Split Type: vsafe

Write-up: Right arm swelling very bad right after shot, next day woke up to get ready to work I started to get light headed, dizzy, sweating, felt like I was going to pass out. My husband then called 911. They took me to Hospital ,I stayed there for a couple hours then released. They told me to stay home and the next day I felt fine. I did a televisit with my Nephrologist (Kidney doctor) the following week.


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