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

This is VAERS ID 1081538



Case Details

VAERS ID: 1081538 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with previous history of sangioedema reaction to vaccine or medication received J&J COVID single dose vaccine and had throat and chest tightness. Treated by EMS, transported to hospital. The vaccine does not require a second dose. CDC recommendations are that no further action is needed at this time.


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