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From the 6/11/2021 release of VAERS data:

This is VAERS ID 904029

Case Details

VAERS ID: 904029 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Mississippi  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cyanosis, Dizziness, Dyspnoea, Full blood count, Livedo reticularis, Metabolic function test, Mobility decreased, Muscle spasms, Muscular weakness, Nail bed disorder, Paraesthesia, Pregnancy test, Pruritus, Rash, SARS-CoV-2 antibody test, SARS-CoV-2 test, Skin discolouration, Syncope, Urticaria, Weight bearing difficulty
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? Yes
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: Topamax 50mg daily, Celexa 10mg daily, Imitrex 100mg PRN
Current Illness: None
Preexisting Conditions: Migraines
Allergies: PCN- unknown reaction, was just always just told was, but no history of a anaphylaxis and able to tolerate cephalosporins.
Diagnostic Lab Data: Cbc, cmp, rapid COVId PCR, Covid antibody, pregnancy test
CDC Split Type:

Write-up: 15 minutes after getting the vaccine began itching that quickly developed into rash/hives to face, neck, chest, abdomen. At 20 minutes post vaccine developed severe leg weakness with lightheadedness, chest tightness, and SOB. 22 minutes out collapsed to the floor unable to bear weight due to leg weakness and had severe cramping and tingling in legs, still unable to move them. Was rushed to the ER from employee health and arrived approximately 30 minutes post vaccine administration at that time there was significant mottling to arms and hands with polar nail beds. Vital signs were stable, no strider. Given Solumedrol, Benadryl, and Pepcid STAT. Rash/hives and SOB improved, but legs weakness/tingling, cramping did not and noted purple feet with cyanotic nail beds and mottling to hands/ arms that would come and go. Rash/hives reappeared much worse 2 horse post meds to face, neck, and upper chest. Was given another series of Solumedrol and Benadryl and admitted to the hospital. I am now 19 hours post vaccine with improved but persistent leg weakness, now able to bear my own weight independently and walk a few steps, but still having legs cramps and intermittent tingling to feet. Color has improved with resolved mottling/cyanosis. I continue to have hives reappear with scheduled Benadryl, Solumedrol, and Pepcid.

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