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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1213084

Case Details

VAERS ID: 1213084 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Fatigue, Full blood count, Headache, Muscle spasms, Nausea, Pain, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: amoxicillian
Diagnostic Lab Data: CBC-unknown results CT Scan-unknown
CDC Split Type: vsafe

Write-up: About 5pm after the vaccine I developed a cramp in my left leg, felt really tired and the fever began. About 10pm the symptoms got worse so I took nyquil because I was feeling horrible. My fever elevted to 101 causing me to have a seizure. EMT transported me to the ER about 12midnight and I was given meds for nausea, pain and monitored and about 3:30am I was released. The next day I was really tired, fatigued and had a really bad headache but by that Wed all symptoms had subsided.

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