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

This is VAERS ID 1185264



Case Details

VAERS ID: 1185264 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dysphonia, Feeling abnormal, Pallor, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9:40 BP 73/56, HR 50, O2 95% 10:05 BP 70/systolic HR 47
CDC Split Type:

Write-up: 9:45 c/o dizziness, "foggy" brain 9:48 throat tightness, pale lips 9:50 epi injection 9:52 Benadryl 50mg IM 9:58 throat sill tight, speech slightly hoarse 10:05 A + O x3, Throat tightness, speech clear EMS transported to ER


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185264


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