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

This is VAERS ID 919546

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Case Details

VAERS ID: 919546 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:2020-12-29
Onset:2021-01-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Antinuclear antibody positive, Antiphospholipid antibodies, Aphasia, Blood cholesterol increased, Blood homocysteine, Coagulation time, Craniotomy, Low density lipoprotein increased, Mechanical ventilation, Thrombotic stroke
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (narrow), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Lipodystrophy (broad), Respiratory failure (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plaquenil Fioricet Midrin
Current Illness: PMH- Lupus; HTN; marked hyperlipidemia
Preexisting Conditions: Lupus Hypertension Hyperlipidemia
Allergies: None listed
Diagnostic Lab Data: Total cholesterol- 465 LDL- 351 ANA (+) Labs pending- Lupus AC; antiphospholipid AB, homocysteine levels; hypercoagulability profile
CDC Split Type:

Write-up: thrombotic stroke -necessitating hospitalization; and craniotomy; required mechanical ventilator for 2 days. Patient now extubated, breathing on her own. Patient remains hospitalized with marked deficits (aphasic)


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