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

This is VAERS ID 1772779

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Case Details

VAERS ID: 1772779 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Condition aggravated, Dizziness, Fatigue, Feeling abnormal, Feeling hot, Heart rate increased, Loss of consciousness, Mobility decreased, Nausea, Pain, Visual impairment, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Standard Process all natural vitamins and supplements.
Current Illness: Leaky gut has been treated for months with positive changes and dietary improvement.
Preexisting Conditions: Food allergies and neurological assessment in 2020 for MS like symptoms with tingling and exhaustion linked to metals toxicity (aluminum and mercury build up in test) and leaky gut.
Allergies: Peanut and tree nut. Gluten intolerance.
Diagnostic Lab Data: Chiropractic adjustment and symptom reporting at Functional Medicine doc on October 4.
CDC Split Type:

Write-up: At 5pm on Sept 28 I felt body aches come on suddenly, a temperature of 99.6 with Tylenol began at 7pm. Strong nausea and exhaustion with 99.6 temp continued throughout the night. The next morning I woke up to teach from home and at 5:20am I apologized to my student as my field of vision became narrow and dizziness came over me I passed out on to the floor and my husband found me and gave me water. I stayed in bed from 5:30am until 8pm. I ate two bites of a gluten free waffle at 10am and threw up at 11am and returned to bed. My temperature finally regulated at 9pm on September 29. All symptoms subsided by 10:30pm on September 29. I then began experiencing daily strong heartbeats and a warming sensation under y skin beginning September 30th. This sensation is constant and unusual. Yesterday I went with my family to the zoo and pushing my sons stroller made my heart hurt in my chest, so my husband took over pushing the stroller. I am an active mom and this is very abnormal for me. My resting heart rate is 74 tonight as I''m feeling off.

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