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

This is VAERS ID 1140111



Case Details

VAERS ID: 1140111 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood glucose, Computerised tomogram, Dysarthria, Facial paralysis, Laboratory test, Magnetic resonance imaging, Muscle strength abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), 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), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: estradiol, gabapentin, mirtazapine, pantoprazole, promethazine, tizanidine
Current Illness: recent hiatal hernia repair recent bells palsy
Preexisting Conditions: anxiety depression
Allergies: ancef, Percocet, reglan
Diagnostic Lab Data: CT, MRI/MRA, labs, glucose, given TPA
CDC Split Type:

Write-up: had syncope approx. 15 mins after injection - after pt aroused she was noted to right have facial droop, slurred speech, dysarthria, 2/5 strength to RLE, 4/5 strength to RUE.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1140111


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