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

This is VAERS ID 1038305

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Case Details

VAERS ID: 1038305 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest X-ray normal, Chest pain, Cold sweat, Colonoscopy abnormal, Computerised tomogram abdomen normal, Computerised tomogram spine, Endoscopy, Faeces discoloured, Fear, Haematochezia, Headache, Hyperhidrosis, Inflammation, Large intestine polyp, Myalgia, Pain, Pain in extremity, Platelet count decreased, Polypectomy, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Thrombosis, White blood cell count increased, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal premalignant disorders (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hospital did a CT of my abdomen, COVID testing and related blood work etc., see MyChart for all the details - to lengthy to list here. Hospital did over 80 tests, two CTs (abdomen and lower spine), X-rays of hands for arthritis and extensive blood and other tests all posted in MyChart but to extensive to list here.
CDC Split Type:

Write-up: On January 21, 2021 I started feeling pains in my right shoulder (1st shot was left shoulder) and the following day it had spread across my body, shoulders, chest, arms, legs and calves. I also had a severe headache along with the muscle pains and woke up each day since in a pool of sweat with the sheet soaked to this day. Due to the severe muscle pains, I started taking Tylenol and all the symptoms pointed to the virus itself. I was tested for the virus on Monday, January 25th with negative results on the morning of the 26th. I continued to self-medicate with Advil every four hours to remove the severe muscle pains noted above. To back track slightly, I had a colonoscopy on January 19, 2021 and one large polyp was removed without issue. Due to the full body muscles pains and taking the Advil, it likely caused bleeding from the polyp site of the colonoscopy and went to the ER and they transferred me back the hospital on January 28, 2021, the location of the colonoscopy, and hospital found nothing wrong with the colonoscopy during my 2.5 day stay there. The did an x-ray of my chest to test for the flu and related items and found everything to be clear. They also a CT of my abdomen to look for any abnormalities and found none. Through all this the muscle pains continued when I would move, the muscles would fire up and intense pain persisted until I could calm them down after about 30 mins of intense pain. Hospital also tested me twice for the COVID virus and each turned out negative. Overall, I?ve been tested for the virus nearly 12 times and all were negative. From the visit to Hospital, with the colonoscopy and no additional bleeding occurring, Hospital gave me a steroid called Prednisone to mask the pain on Saturday, January 30, 2021 at about 1pm and by 4pm they fully released me with no idea what was causing the severe muscle pain across my body when I moved. I literally just walked out of the hospital since the steroid masked the muscle pain issue. The steroids worked but I was still walking up in a pool of sweat and very clammy and wet each morning from 1am until I woke up. On February 2, 2021 I had 3 bowel movements that were all dark purple and full of blood clots which led me back to Hospital and the ER could not get in touch with the Hospital Doctors for transfer so they admitted me to the Hospital, thank God. On February 4, 2021 Methodist performed an emergency colonoscopy to clamp the polyp site, took two additional polyps out and did an endoscopy to ensure my upper and lower GI track were clear, and it was and the two additional polyps were benign. Through all this the serve muscle pains persisted and Hospital moved me to a patient room and out of the ER. Over the next several days, February 4 thru the 11th Hospital cleared me of everything they could test for, over 85 different tests were ran based on MyChart. All my blood counts were all over the place, WBC were 19,000, Platelets were nearly 700, my sedimentation rate reached 64+ and the server muscle pains persisted and I was basically incapacitated during my entire stay at Hospital. Hospital had several specialists seem me from Internal Medicine, Infectious Disease, Neurology to Rheumatoid ologist and none of them found anything wrong with me other than my COVID anti-bodies were enormously high with not signs of slowing down. The conclusion by each of the specialist is that my symptoms all point to an Adverse Level 3 Inflammatory Reaction to the first COVID Vaccine shot. The Infectious Disease specialists emphasized that I DO NOT get the second vaccine shot since it would like have killed me. (We had cancelled my 2nd shot, scheduled for February 3, 2021 via Cancer Center the week of January 30, 2021.) Hospital concluded that they could not do anything further for me since all their extensive testing all came up negative other then the COVID antibody levels and started me on the same steroid via IV on February 10, 2021 and on February 11, 2021 I was released from Hospital with a 28-day gradual reduction of the steroid over that timeframe to see if the COVID antibody production would simply stop. They had no other recourse or follow up with for any of the specialists. I?m on my own at this point and scared. To help with the inflammation the only thing my wife and I saw we could do is see a health and well Doctor to try and purge myself of the inflammation and assist my bowel and liver health with trying to rid me of the vaccine and hopefully the antibody production. I?m on a strict diet and taking supplements to assists in the reduction of inflammation and cleaning my system out. Starting today, February 18, 2021 I start stepping back on the steroids prescribed by Hospital and praying that the symptoms and pain simply go away but I?m still having night sweats, weak and shaky.

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