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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1020449

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Case Details

VAERS ID: 1020449 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: California  
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, Gastrointestinal haemorrhage, Haemoglobin decreased, Melaena, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: combigan, Colace, ferrous sulfate, xalatan, and Tylenol as needed
Current Illness: none
Preexisting Conditions: glaucoma, arthritis
Allergies: none
Diagnostic Lab Data: 2/8/21 hg,b=4.8, plt=4 2/9/21 hgb=5.8, plt=2 2/10/21 hgb=7, plt=7
CDC Split Type:

Write-up: melena, severe anemia, gi bleed and severe thrombocytopenia

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