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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1172442



Case Details

VAERS ID: 1172442 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-03-29
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1B02072 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Rash, SARS-CoV-2 test, Streptococcus test
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Goli
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: strep test and COVID test
CDC Split Type:

Write-up: Rash over most of the trunk area, head and neck.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1172442

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