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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1184592



Case Details

VAERS ID: 1184592 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: warfarin
Current Illness: none
Preexisting Conditions: factor v leiden
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA headache, fever, fatigue, soreness of arm - as of this date, April 9, 2021; 9:30 am. I expect to recover, but reporting these side effects for your information


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1184592


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