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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1714939

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Case Details

VAERS ID: 1714939 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-09-11
Onset:2021-09-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Anticoagulant therapy, Cerebral arteriosclerosis, Hemiparesis, Vertebral artery occlusion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: smokes cigarettes
Current Illness: none known
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: IMPRESSION: (CTA) 1. Occlusion or dissection of the right vertebral artery shortly after the origin with reconstitution of the cervical V3 segment at the C2 level. There is asymmetric diminished attenuation of the V4 segment. 2. Left posterior cerebral artery P1 segment moderate atherosclerotic disease.
CDC Split Type:

Write-up: Patient woke with left hemiparesis went to the emergency room at Hospital. patient received IV heparin with resolution of hemiparesis. Medical records show that patient was advised hospitalization is stroke center declined and left against medical advice. On my evaluation on September 20, 2021 there have been no recurrence of symptoms


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