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

This is VAERS ID 1768147

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Case Details

VAERS ID: 1768147 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Restlessness, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine calcium vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Woke up in the early morning hours after receiving the shot midday with extreme chills, teeth chattering and feeling feeling totally drained. Went back to bed, could not stop shivering and teeth chattering but eventually fell back asleep, albeit fitfully. That morning, I woke and the chills had gone but I still felt totally drained and spent the remainder of the day -- until about 3 pm -- in bed, sleeping on and off. Felt better -- though still weak. Took two days, but am now feeling pretty normal.


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