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

This is VAERS ID 1775612

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Case Details

VAERS ID: 1775612 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Pain, Pyrexia, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Zoloft 25mg; Flomax 0.4mg; Lipitor 10mg; Lipo Flavonoid;
Current Illness: None
Preexisting Conditions: High Cholesterol; Benign Prostate Hyperplasia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day of (MON) - soreness at injection site, achy in the evening. NIGHT OF - "Whole body Restlessness" - kept waking up having to move my body, like Restless Legs only including the torso. Day after (TUE) - soreness at injection site, 100 degree fever, fatigue. Spent most of the day in bed. 2nd day after (WED) - soreness at injection site, some fatigue. 3rd day after (THU) - mild fatigue Never had the "Whole body Restlessness" again.


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