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

This is VAERS ID 1374279

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Case Details

VAERS ID: 1374279 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Louisiana  
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Blood test, Dehydration, Dyspnoea, Renal disorder, Renal failure, Sluggishness, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I was taking Flexeril, Norco, Sulindac, Gabapentin, Amloditin, Apresoline, Losartin, Dymista, Boltaren gel, Ditrotan, Fluoxetin, Lovastatin, Albuterol, Duloxetine, Cored, Reglan, Protonix, Estrabiol, Zytex, Aspirin.
Current Illness: No.
Preexisting Conditions: I have high blood pressure, high cholesterol and heart condition.
Allergies: I am allergic to Ematrix.
Diagnostic Lab Data: blood work ultrasound
CDC Split Type: vsafe

Write-up: I was at work and feeling sluggish and couldn''t hardly breathe. I went to the hospital and was told my kidneys were failing and my blood pressure was dropping lower and lower. My kidneys were dehydrated and I needed to get fluids.

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