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

This is VAERS ID 1761033

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Case Details

VAERS ID: 1761033 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Nausea, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Keppra-for epilepsy Clonazepam- for epilepsy Remeron- for long haul COVID-19 to help with appetite Tylenol and Ibuprofen to hep with muscle aches and fever form vaccines.
Current Illness: Long Haul Covid-19 diagnose in April- mar 2021. Epilepsy diagnosed 9 years ago
Preexisting Conditions: Epilepsy Long Haul COvid-19
Allergies: Scallops Lidocaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever of 103, seizure hours after vaccine, chills, headache, nausea, diarrhea


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1761033


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