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From the 10/8/2021 release of VAERS data:

This is VAERS ID 133268

Case Details

VAERS ID: 133268 (history)  
Form: Version 1.0  
Age: 61.0  
Sex: Female  
Location: Nevada  
   Days after vaccination:0
Submitted: 2000-01-06
   Days after onset:57
Entered: 2000-01-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Face oedema, Generalised oedema, Insomnia, Migraine, Speech disorder, Thinking abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fosamax
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: Nuclear MRI-neg blood work-reportedly neg
CDC Split Type: 0302405JAN

Write-up: That evening, developed swelling of lt half of her head, face and eye which also extended from the left side of her neck to her collar bone. She had confusion in thinking, mispronouncing of words, insomnia & each day had "terrific" migraine

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