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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1693559

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Case Details

VAERS ID: 1693559 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyskinesia, Feeling cold, Rash, Rash pruritic, Seizure like phenomena, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: fluoxetine 20 tablet, myrbetriq er 50 mg tab, ibuprofen 600 mg tab, estradiol 0.01% cream, rosuvastatin 5 mg tab, levothyroxine 100 mcg tab, ezetimibe 10 mg tab, fluoxetine 10 tab
Current Illness: n/a
Preexisting Conditions: osteoporosis, high cholesterol, hypothyroidism, heart disease
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called pharmacy 09/12/2021 in the afternoon stating that she wanted to report an adverse event. She stated that on Friday night she experienced chills so cold it felt like she was in a freezer. She also stated that she felt she had seizure-like contractions, arms were jerking, and has pink plaque on both arms and they are itchy. She did not go to the hospital. She had been taking benadryl and using a heating pad to soothe herself. She said that she will reach out to her doctor tomorrow.

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