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

This is VAERS ID 1137244



Case Details

VAERS ID: 1137244 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Drooling, Paraesthesia oral, Tachycardia, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Dehydration (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, obesity, bipolar disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Obtained from patient. Patient is a 37-year-old female with past medical history of asthma, bipolar disorder, history of anxiety and joint pain, came to Emergency Room with above complaints. Patient works as a investigator and getting her first COVID-19 vaccination, Johnson and Johnson. Patient was at work receiving her first dose. After dose, the patient was planned to be observed. The patient is stating that 3 minutes, the patient started getting her tongue started feeling funny. Four minutes into vaccination, patient felt her throat was closing and the patient started drooling. Nurse practitioner immediately gave the patient 2 shots of epinephrine with Benadryl. 911 was called and patient was admitted to the Emergency Room. In the Emergency Room, the patient diagnosed with anaphylactic reaction to COVID-19 vaccination. With the patient''s persistent tachycardia, still having symptoms of throat itching, the patient requested to be admitted for further observation.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1137244


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