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

This is VAERS ID 1149738



Case Details

VAERS ID: 1149738 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid abnormal, Cerebral artery occlusion, Cerebrovascular accident, Computerised tomogram head abnormal, Computerised tomogram neck, Fibrin D dimer increased
SMQs:, Haemorrhage laboratory terms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D2, loperamide PRN, multivitamin
Current Illness: Breast cancer treated in 20 with partial mastectomy, treated with chemo, radiation
Preexisting Conditions: Breast cancer treated in 20 with partial mastectomy, treated with chemo, radiation
Allergies: None
Diagnostic Lab Data: -CT/CTA of the head and neck demonstrating a large vessel occlusion in the right MCA territory. Patient underwent TPA therapy. Market improvement and examination. Overall currently doing well. Patient?s labs notable for D dimer elevated greater than 21,600 (greater than assay)? She has multiple reasons to have an elevated D dimer including having a stroke, cancer, and recently having receive TPA therapy. Again, unclear to us whether or not these events are causative, coincidental, or otherwise. But we felt it was reasonable to report
CDC Split Type:

Write-up: Patient presented to Medical center with right sided MCA stroke (proximal M1) occlusion. She underwent tPA therapy and is recovering. She has a history of breast cancer that was treated in 2017. It?s unclear to us whether or not these events are related. However, given the thrombosis occurred on the same day as the vaccine was administered, we felt it was a reportable event


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1149738


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