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From the 11/12/2021 release of VAERS data:

This is VAERS ID 953136

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Case Details

VAERS ID: 953136 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-15
Onset:2021-01-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Feeling abnormal, Flushing, Hyperhidrosis, Local reaction, Oropharyngeal discomfort, Pain, Paraesthesia oral, Petechiae, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Evening after receiving vaccine, felt "fuzzy, full feeling in tongue and throat". No breathing issue. Fever (101 degree) and rash (all over body, red, flat petechiae) developed 24 hours after vaccine with diaphoresis and general skin flushing, body aches and, severe local arm reaction. All symptoms resolved after 48 hrs.


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