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

This is VAERS ID 1180807



Case Details

VAERS ID: 1180807 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: patient was vaccinated at 10:55 by 11:00 was anxious and pacing with tachycardia and sweating. at 11:05 patient was given 50mg diphenhydramine in liquid form (20cc) and EMT personnel arrived at 11:15 to evaluate patient. Patient chose to go hospital for evaluation


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1180807

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