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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1079627



Case Details

VAERS ID: 1079627 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-04
Onset:2021-03-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neck pain, Oropharyngeal pain, Pharyngeal swelling, Skin mass, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: DEVELOPED SWOLLEN THROAT GLANDS, SORE THROAT, SWOLLEN FACE, KNOT UNDER CHIN, PAIN AROUND NECK


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1079627


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