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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1270488

Case Details

VAERS ID: 1270488 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maryland  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blindness, Brain natriuretic peptide, Chest discomfort, Computerised tomogram, Dizziness, Dyspnoea, Dysstasia, Eye pain, Fatigue, Fibrin D dimer, Pain, Palpitations, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: oral birth control (tri-lo-marzia)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 4/16/21 - visit to primary care physician 4/20/21 - blood draw - results show high d-dimer (.95) and elevated Pro B Type Natriuretic Peptide (152 pg/mL) 4/22/21 - admitted to emergency room, ct scan showed no blood clots in chest
CDC Split Type:

Write-up: I had to go to the emergency room, high d-dimer (.95), elevated Pro B Type Natriuretic Peptide (152 pg/mL) ---Days 1-2 (12-22hrs post-vaccine) were horrific - fever, body aches, extreme pain everywhere, my eyes hurt so bad I thought I''d lose my vision, I was in so much pain that I couldn''t talk to ask for help. Saying they were flu-like symptoms is a euphemism. ---Days 2-9 I was weak and shaky on my legs, easily winded (e.g. breathing hard when doing laundry). Fever returned off and on. ---Days 4-13 It felt like someone was sitting on my chest. ---Day 10 I had a blood draw per my doctors request. ---Day 12 Blood draw results showed high d-dimer, and my doctor told me I need to go to the ER for a ct scan to look for blood clots. ---Day 12 Went to Emergency Department - ct scan showed no clots, but elevated Pro B Type Natriuretic Peptide ---Day 15 Finally started feeling better, but still winded easily, fatigued, dizziness, heart palpitations

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