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

This is VAERS ID 1185528



Case Details

VAERS ID: 1185528 (history)  
Form: Version 2.0  
Age: 42.0  
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 LL / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure measurement, Heart rate, Nausea, Oxygen saturation, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Paxil, Gabapentin, Aldactone
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10:17 BP 100/39 HR 42 O2 95% 10:20 BP 102/63 HR 77 O2 98% 10:27 BP 114/60 EMS arrived
CDC Split Type:

Write-up: Started feeling tingling to face and closing to throat some nausea, zero dizziness, zero SOB except feeling throat is still closing 10:18 Benadryl given IM 10:20 epinephrine


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185528


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