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

This is VAERS ID 390263

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Case Details

VAERS ID: 390263 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Female  
Location: New York  
   Days after vaccination:11
Submitted: 2010-06-08
   Days after onset:169
Entered: 2010-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Chest pain, Muscle spasms, Muscle twitching, Myalgia, Neutrophil count decreased, Pain, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: none
Current Illness: None known - please note this was administered at my prior office and I do not have the records. The 3rd dose was administered on the above date per patient but other dosing dates not now available
Preexisting Conditions: none
Diagnostic Lab Data: Have started laboratory work-up. Abnormal WBCs (low WBCs and neutrophils) and plan to refer to hematology.
CDC Split Type:

Write-up: This is an estimate of the date. Patient took bus and developed cramps in calf muscles. Went to ER -- negative DVT. Pain then generalized. Now with generalized muscle achiness/pain (more in extremities), twitching, popping sensation in joints, now also shooting pains in chest.

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