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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1130546



Case Details

VAERS ID: 1130546 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Eye swelling, Pain, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: During the day that I was administered the vaccine I had pain in my arm (area in where I was vaccinated). The next day, I woke up with general pain in the body, pain in the arm where the vaccine was injected and it swelled up a little the skin under the eyes (hives). As the day goes by, the pain in the arm has diminished, as well as the hives in the eyes.


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