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

This is VAERS ID 1457028

Case Details

VAERS ID: 1457028 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Bell's palsy, Dizziness, Facial asymmetry, Hypoaesthesia, Vision blurred, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prostate cancer (CMS/HCC) 2005 s/p prostatectomy ? Right inguinal hernia ? Urinary incontinence mild
Allergies: Scallops
Diagnostic Lab Data: Seen in Emergency Department on 07/02/21 07/07/21 Seen by Nurse practioner in a neurology clinic
CDC Split Type:

Write-up: Left sided Bell''s palsy Eyes: Positive for visual disturbance ( Blurred vision in the right eye Neurological: Positive for dizziness ( When he closes eyes.), facial asymmetry ( Left-sided facial droop), speech difficulty and numbness ( To the right side of the face). Negative for weakness and headaches.

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