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

This is VAERS ID 1117742

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Case Details

VAERS ID: 1117742 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Termination of pregnancy and risk of abortion (narrow)

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: Prentala vitamins
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain at injection site starting one day after 2nd pregnancy (first was miscarriage), due date November 12


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