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

This is VAERS ID 1185890



Case Details

VAERS ID: 1185890 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Missouri  
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 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chest discomfort
SMQs:, Anaphylactic reaction (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: none
Preexisting Conditions: none
Allergies: Shellfish, Seasame, "like every plant"
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Anxious and tightness in chest/diaphargm


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185890


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