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

This is VAERS ID 988042

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Case Details

VAERS ID: 988042 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-01-18
Onset:2021-01-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dermatitis atopic, Pain, Rash, Rash pruritic, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: triamcinolone acetonide (KENALOG) 0.5 % Cream levocetirizine (Xyzal) 5 mg tablet clobetasoL (TEMOVATE) 0.05 % Cream Eucrisa 2 % Ointment mupirocin (BACTROBAN) 2 % Ointment ASHLYNA 0.15 mg-30 mcg (84)/10 mcg (7) Tablet, Dose Pack, 3 Months a
Current Illness:
Preexisting Conditions: Eczema, Autism, OCD, Depression, Overweight
Allergies: Benadryl, Robitussin
Diagnostic Lab Data: She had a negative COVID PCR test 5 days post vaccine.
CDC Split Type:

Write-up: Starting 5 days after her 1st Moderna COVID vaccine, she started to break out in a pruritic migratory rash, abdomen, trunk, arms, feet, face, comes and goes, migratory, looks consistent with known atopic dermatitis, worsening after the vaccine with nothing else new introduced. She also had body aches and viral symptoms 5 days post-vaccine. The rash is still present 11 days post vaccine.


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