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

This is VAERS ID 953397

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Case Details

VAERS ID: 953397 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / SC

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Headache, Herpes zoster, Immune thrombocytopenia, Platelet count decreased
SMQs:, Severe cutaneous adverse reactions (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC: platelet 70 in ER 01/16/2021 Platelet 29 01/17/2021 After steroid treatment going up to 45 01/18/2021
CDC Split Type:

Write-up: 1day after vaccine,developed severe headache & later blister in head officially Shingle . Then decreased platelet count fatally to 29(ITP).now hospitalized getting treatment.


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