From the 3/29/2024 release of VAERS data:

This is VAERS ID 1510721

Government Disclaimer on use of this data

Case Details

VAERS ID:	1510721 (history)
Form:	Version 2.0
Age:	27.0
Sex:	Male
Location:	Hawaii

Vaccinated:	2021-06-22
Onset:	2021-06-23
Days after vaccination:	1
Submitted:	0000-00-00
Entered:	2021-07-28

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA	- / UNK	- / -

Administered by: School Purchased by: ?
Symptoms: Alopecia, Blood urine present
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

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: None
Current Illness: I got Covid a month before I got vaccinated.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: side effects of blood in urine and hair loss

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