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From the 4/30/2021 release of VAERS data:

This is VAERS ID 1131609



Case Details

VAERS ID: 1131609 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia oral, Orbital swelling, Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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:
Current Illness:
Preexisting Conditions:
Allergies: anaphylaxis - oral sulfas
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has PMH of anaphylaxis to PO sulfa drugs, red-syndrome to IV vancomycin and multiple food and environmental allergies. Physician and patient underwent shared decision making process in regards to getting vaccination. - 13:10, pt received shot. - 13:20, pt reports L orbital swelling and numbness/tingling in L upper lip. Given 50mg diphenhydramine. Lungs CTAB. Airway non-edematous. No visible abnormalities or facial edema. O2 sat 98%. HR 77. - 13:30, pt states that tingling has not subsided. Reports that symptoms are mild compared to historical allergic reactions. - 13:35 - pt discharged with instructions to take diphenhydramine Q 4-6 hours for 24 hours and to discuss reaction with PCP (pt already had appt scheduled on same day).


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