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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1354832

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Case Details

VAERS ID: 1354832 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Cough, Ear pain, Facial pain, Fatigue, Headache, Influenza like illness, Influenza virus test, Nasal congestion, Pain in extremity, Pyrexia, Rhinalgia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: Covid test through nasal and swab
CDC Split Type: vsafe

Write-up: I experienced after 24 hours, I felt chills, fever, fatigued, horrible headaches, left sore arm and then my symptoms went away. On 04-22-2021, I experienced nasal congestion, pain in my nose, cheeks, ears, pain to the back of my head, lost my tense of smell and taste and had real bad cough. The doctors treated me as Covid, I did got tested twice for Covid but my results came back negative. The doctors treated me as a Covid symptoms. I also got tested for flu through my nose. I went to a military station to get my first covid test and my second was at an urgent care. After two weeks my symptoms of flu-like symptoms, headaches and fatigued went away. On 4-22-2021 I can say that the same symptoms that I experienced, my daughter and husband also get the same symptoms and it was significant amount of nasal drainage, cough and flu-like symptoms.

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