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From the 5/7/2021 release of VAERS data (an older release, current is 11/12/2021):

This is VAERS ID 937518

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Case Details

VAERS ID: 937518 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2020-12-30
Onset:2021-01-11
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Epistaxis, Laboratory test, Swelling face, Thrombosis
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LABS RESULTS PENDING WITH PCP
CDC Split Type:

Write-up: LEFT FACIAL SWELLING WITH LARGE AMOUNT OF NASAL BLEEDING AND CLOTTING. SHE SAW HER PCP AND HAD LAB TESTING AND GIVEN BENEDRYL. SHE WILL F/U WITH PCP AGAIN TODAY.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=937518


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