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

This is VAERS ID 1081451



Case Details

VAERS ID: 1081451 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-04
Onset:2021-03-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood test, Chills, Headache, Nausea, Pyrexia, Urine analysis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: Gardasil (passed out immediately after receiving vaccine), aged 21
Other Medications: Alprazolam 0.5mg, metoprolol succinate 25mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Ceclor, stadol
Diagnostic Lab Data: Bloodwork and urinalysis (3/6/21)
CDC Split Type:

Write-up: Fever, chills, nausea, severe headache (still on-going), severe lower back pain (still on-going)


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1081451


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