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

This is VAERS ID 1185908



Case Details

VAERS ID: 1185908 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
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 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Limb discomfort, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: Hydrocodone PRN. None today, last dose was yesterday at 8:00 PM
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of left arm heaviness at 12:44pm. BP was 158/98 Pulse was 101 and O2 saturation was 99. No other complaints at that time. After observation period patient went to the bathroom around 1:00pm and vomited in the restroom. She returned to post vac area where BP was checked (208/124) Pulse (107), O2 saturation (98), and respirations were at 28. No blurred vision, shortness of breath, or dizziness. Due to elevated BP we elected to call EMS for further evaluation. While waiting for EMS BP was taken again at 1:30 pm and it was 170/92 and pulse and apical HR were at 96, respirations at 24, O2 Sat at 97% and pt. reported arm was less heavy but she felt a tingling sensation from her arm to her wrist. EMS arrived at 1:35 and BP was 220/120 and temp was at 97 degrees.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185908


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