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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1446478

Case Details

VAERS ID: 1446478 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Cardiac monitoring, Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Headache, Injection site pain, Nausea, Neck pain, Nitrite urine present, Pain, Protein urine present, Rash, SARS-CoV-2 test, Urinary tract infection
SMQs:, Acute renal failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan for PE 6/26, XR chest 6/26, cardiac monitoring 6/26, COVID test 6/26, positive nitrate 6/26, 30 MG protein in urine 6/26, nitrate in urine 6/26, large leukocytes 6/26, rash on arms
CDC Split Type:

Write-up: Chest pain, upper back pain, shortness of breath, O2 at 90% on room air, pain radiating from injection site down arm, headache, pain down left side of neck, nausea, UTI, rash

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