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

This is VAERS ID 1371923

Case Details

VAERS ID: 1371923 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin normal, Blood urine present, Chromaturia, Fibrin D dimer increased, Full blood count normal, Gait disturbance, Influenza A virus test negative, Influenza B virus test, Musculoskeletal pain, Myalgia, Myoglobin blood present, Myositis, Pain in extremity, Protein urine present, Renal function test normal, Respiratory syncytial virus test negative, Rhabdomyolysis, SARS-CoV-2 test negative, Troponin normal
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: nil
Current Illness: nil
Preexisting Conditions: nil
Allergies: nil
Diagnostic Lab Data: bloods: CBC, clotting and renal chemistry and troponin within normal limits 2 jun and 3rd Jun 2021 d-dimer and myoglobin positive (qualitative tests only available) 2 Jun 2021 liver biochem - ALT 81, AST 279 U/l on 2 Jun, and ALT 357, AST 1368 U/l on 3 Jun 2021. Bilirubin etc normal. urine: dark red/brown colour. Positive dip for blood and protein 2 and 3rd Jun 2021 viral: PCR negative for SARS-CoV2, Influenza A&B and RSV negative 2 jun 2021
CDC Split Type:

Write-up: initially no symptoms until on day 8 after vaccine (1 Jun 2021), rapid onset progressive severe muscular pains in calves, thighs, buttocks and then upper arms. Within 24 hours unable to walk easily. No other symptoms and no physical signs of infection. Urine became dark brown at 24 hours and clinically has myositis with suspected rhabdomyolysis - was admitted for iv fluids and analgesia and is improving clinically but gait still disturbed. No demonstrable weakness and no neuro deficit or symptoms. no other obvious cause for acute myositis so consider ?vaccine related.

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