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

This is VAERS ID 1173672



Case Details

VAERS ID: 1173672 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg, calcium + vitamin D, omega 3 fatty acid, multivitamin, B complex
Current Illness: no
Preexisting Conditions: HTN
Allergies: IV contrast, motrin, penicillin, pineapple, premarin, prevacid, shellfish, sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1 hour after vaccine, developed facial swelling. went to ER. Given Benadryl 50 mg. Next day better. Continued to take Benadryl and zyrtec for 3 days, controlled. 2 days after stopping, began to have facial swelling around the eyes. No oral swelling, shortness of breath, or hives.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1173672

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