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From the 3/14/2020 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 861839



Case Details

VAERS ID: 861839 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2020-01-14
Onset:2020-02-08
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20200314&IDNUMBER=861839

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