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

This is VAERS ID 1782926

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Case Details

VAERS ID: 1782926 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Headache, Hypertension, Impaired work ability, Insomnia, Malaise, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Hypertension (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair Diskus, albuterol, levothyroxine, montelukast, pantoprazole, Xyzal
Current Illness:
Preexisting Conditions: Asthma, vitamin D deficiency, hypothyroidism, hyperlipidemia, elevated liver enzyme, steatosis of liver, GERD
Allergies: Phentermine, Qsymia?All non-allergic reaction, mostly intolerance to the medication
Diagnostic Lab Data: None other than COVID-19 testing 10/1/2021
CDC Split Type:

Write-up: Patient had loss of taste, loss of sense of smell after getting the vaccine. She also started having headaches from 9/30/2021?10/11/2021. Patient had difficulty sleeping and felt really ill despite intake of Motrin, Advil, Excedrin. She noted blood pressure to be high at 141/91. She was tested for COVID-19 10/1/2021 and resulted negative. Reaction was severe enough that patient could not go to work for that entire time. She was able to go back to work 10/12/2021.

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