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From the 5/14/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 914673



Case Details

VAERS ID: 914673 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ecchymosis, Purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Abilify, diclofenac gel, lamictal, lorazepam, metro gel, naltrexone, naproxen, omperazole, promethrazine, propranolol, nurtec, topamax, trazodone
Current Illness: None
Preexisting Conditions: Bipolar d/o, DM, GERD, migrianes
Allergies: Neurontin (anaphylaxis), clinda (rash), geodon (fainting), imitrex (rash at injection site), pen , prozac, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5-6 cm very round purpuric lesion/ecchoymosis with central clearing


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=914673

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