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

This is VAERS ID 931200

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Case Details

VAERS ID: 931200 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-08
Onset:2021-01-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Flushing, Headache, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog, Singular, Nexplanon, Flonase,
Current Illness:
Preexisting Conditions: Diabetic type 1
Allergies: Sulfa drugs
Diagnostic Lab Data: blood sugar 127
CDC Split Type: 488

Write-up: about 25 minutes after the injection pt felt flushed with mild tachycardia and headache. Pt improved with rest on the exam table. Bp returned to normal immediately and bp remained normal at 126/84. Pt returned to work but sx reoccurred about 30 minutes later and she again rested with resolution of sx until she went home.


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