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

This is VAERS ID 1693792

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Case Details

VAERS ID: 1693792 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Gastrointestinal disorder, Hypoaesthesia, Impaired work ability, Pain, Visual field defect, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: PTSD and Depression from childhood.
Preexisting Conditions: Just been diagnosed after six months of testing, with Small nerve fiber neuropathy. Pain started in my feet and progressively got worse. Now the pain is up to my thighs of pins and needles, shocking, burning, leg spasms, swelling, arms go numb. Gastrointestinal issues along.
Allergies: No
Diagnostic Lab Data: All medical records on file.
CDC Split Type:

Write-up: Gastrointestinal issues Constant pain along with multiple sensations from the soles of my feet to my groin. Numb/dead arm. Vision and peripheral decreased Loss of appetite Over the six to seven months these symptoms progressed. I am currently behind on bills due to missing work due to all the specialists I have had to see. Currently waiting for my appointment to meet the neurologist that I will have to see now for the rest of my life. Medications are being altered to help relieve the pain. This has taken a toll on me. Something I couldn?t afford. I am a single mother of five children who struggled to get herself through school to be a medical assistant after spending 10 plus years being a CNA/Home Health Aid. First it was fighting with my apartment complex to keep hot water on so we can bathe and begging for them to fix the ceiling and water that flooded my kitchen. Now on top of that and million and one things I have to worry about? I also have to worry about fighting to stay alive to see my children grow and marry and have babies.

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