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

This is VAERS ID 1462151

Case Details

VAERS ID: 1462151 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Washington  
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyskinesia, Insomnia, Loss of personal independence in daily activities, Panic attack, SARS-CoV-2 antibody test negative, Self-injurious ideation, Soliloquy, Suicidal ideation, Tachyphrenia
SMQs:, Suicide/self-injury (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Teen girl vitamins - 1 a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On July 4th, Hospital gave her COVID antibody test. They reported it came back negative. What happened? Is it all attacking her brain?
CDC Split Type:

Write-up: 3 days after dose 1, which was given on 05/28/21, PT reported feeling not herself. She was experiencing brain fog and not able to focus on her school work. She was worried about not being able to finish up the school year. We figured it was just "burnout", but knew this was strange behavior for PT who is usually very focused and has no problem getting good grades. We let her get the 2nd vaccine on June 18th. About 10 days later, PT reported feeling like her mind was racing and she could not sleep for 5 nights. She was very anxious and having panic attacks. On July 4th, PT came to us and told us, "the only way to stop the thoughts is to hurt myself." We immediately took PT to the Hospital ER. We have NEVER seen PT like this and she has NEVER had thoughts like this. She was talking to herself, making strange body movements and this frightening behavior came out of nowhere. They kept her overnight and sent her home with referrals to other doctors. She is still having suicidal thoughts and cannot function. We have had to cancel all trips, summer camps and check her out of soccer for the next month. There is no way she is going to be able to go to anything.

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