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

This is VAERS ID 1088806



Case Details

VAERS ID: 1088806 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Muscle rigidity, Muscle tightness, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (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: Synthroid, amplodipine, liothronine
Current Illness: none
Preexisting Conditions: Hypothyroidism, HBP
Allergies: PCN, Tetracycline, novacaine
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was given the Janssen vaccine and within 3 minutes the pt complained that she was lightheaded and dizzy. As I walked out of the pharmacy to see what her reaction was her muscles tensed up and she became completely rigid and stared sliding out of her chair. By appearances it looked like she was shaving a mild seizure, with a blank stare. By the time I got her down on the floor and got her coat off to see if there was an allergic reaction to the site the patient came too and asked me why she was in the floor. At that time she was clamy but knew who she was and where she was. Paramedics were called and while they were here she stated that she was dizzy and nauseous so they ended up taking her to a location hospital to be seen. While there they drew blood as a precaution.


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