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

This is VAERS ID 1180833



Case Details

VAERS ID: 1180833 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Disturbance in attention, Fatigue, Headache, Injection site bruising, Injection site erythema, Injection site irritation, Injection site mass, Injection site pain, Injection site swelling, Injection site warmth, Mobility decreased, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Flu shot = hives for 3 months
Other Medications: Trazadone, Tri-Sprintec, Prozac, Hydroxyine
Current Illness: None
Preexisting Conditions: Asthma and allergies and anxiety
Allergies: Pollen, lactose, dust, thc, cbd, Tylenol brand, penicillin, bunnies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1-Day 3:Sore arm, swollen, hot to the touch, red irritation at injection site, tiredness, trouble concentrating. Day 4-6: arm swollen more, hot to touch, irritation at Injection site, mobility of arm impaired. Day 5: massaged arm to get swelling to go down. Day 6: woke up with massive headache and swelling went down. Day 7: broke out in hives that turned into blisters, taken to ER and given prednisone and antihistamine. Day 8-10: arm is black and blue bruised at injection site, small lump at site, continuous rotating hives and blisters with Prednisone 160mg and antihistamine and creams.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1180833

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