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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1367994

Case Details

VAERS ID: 1367994 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Dyspnoea, Headache, Heart rate increased, Neck pain
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), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Dehydration (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: lisinopril 20 mg daily diclofenac sodium 75mg daily Levothyroxine 0.75mcg daily
Current Illness: none
Preexisting Conditions: hypertension thyroid problems
Allergies: codeine PCN
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 11:55am-10 minutes after receiving the vaccine patient complained of "heart beating a little fast, SOB and feeling woozy". Ambulance was called. BP-115/72, pulse 88, pulse ox 99%, resp 14. 11:59am- LPN administered one 81 mg chewable aspirin per Dr''s request. BP 124/72, pulse 83, pulse ox 99%, resp 14. 11:58am-IV started with NS at KVO per RN. O2 per NC at 2L. Patient c/o neck, left shoulder and head pain. 12:10pm-81 mg chewable aspirin given per Dr''s orders. Ambulance arrived and patient transported to Hospital. Husband notified to meet patient at hospital.

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