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From the 5/7/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 935404

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Case Details

VAERS ID: 935404 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-07
Onset:2021-01-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Discomfort, Injection site pain, Nausea, Petechiae, Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per individual, received dose 1 of Moderna Vaccine on 1/7/21 at workplace clinic. ''Over weekend'' experienced a ''body rash'' (fine red points/petechiae)that encompassed trunk area of body and became increasingly uncomfortable along with sense of nausea and continuous sore arm at site of injection. Patient states use of benadryl has helped with the discomfort of the rash however when medication wears off, itching begins again. Denies any respiratory affects requiring emergency intervention at this time. Patient able to perform duties at workplace. Patient was instructed to talk with the Employee Health Nurse regarding situation.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=935404


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