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From the 6/11/2021 release of VAERS data:

This is VAERS ID 919675



Case Details

VAERS ID: 919675 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-30
Onset:2021-01-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K28 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eyelid function disorder, Facial paralysis, Hypoaesthesia, Lacrimation increased
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Avocado, bananas, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell?s Palsy. Right-sided facial drooping. Numbness to right face. Excessive tearing of right eye associated with inability to blink right eye.


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=919675


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