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

This is VAERS ID 1087806



Case Details

VAERS ID: 1087806 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram, Full blood count, Headache, Joint stiffness, Mental status changes, Metabolic function test, Seizure like phenomena
SMQs:, Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Keppra, Xarelto, Atorvastatin
Current Illness: None stated
Preexisting Conditions: Seizures, history of stroke
Allergies: Penicillan
Diagnostic Lab Data: CT of the head - no acute findings CBC/BMP within normal limits
CDC Split Type:

Write-up: Within 30 minutes post vaccine administration, patient started having seizure like symptoms (Altered mental status, clenched jaw, non-verbal, right sided headache) - V/S WNL, Ambulance called and patient was taken to ED for evaluation. Responsive during transport to ED. Patient reported back to baseline after 1.5 hours.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1087806


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