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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1208468



Case Details

VAERS ID: 1208468 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Balance disorder, Blood test, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Computerised tomogram neck, Dizziness, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Hypertension, Hypoaesthesia, Injection site pain, Limb discomfort, Magnetic resonance imaging abnormal, Myalgia, Paraesthesia, Scan with contrast abnormal, Ultrasound Doppler, Ultrasound scan normal, Venogram abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness: NONE
Preexisting Conditions: MTHFR
Allergies: NONE
Diagnostic Lab Data: ECHO-NORMAL 4/12, EKG-NORMAL 4/11, ULTRASOUND OF RIGHT LEG-NORMAL 4/11, CAROTID ULTRASOUND-NORMAL 4/12, BLOOD WORK, CT W/ CONTRAST OF HEAD&NECK-ABNORMAL4/11, MRI &MRV-ABNORMAL 4/12
CDC Split Type:

Write-up: DAY 1- two hours after vaccine my right arm and right leg felt restricted, numb and had some tingling in my hand, dull headche, muscle pain and dizziness. Day 2- mild pain at injection sight, muscle pain and general tirednes, dull headache,dizzy, right arm& left arm felt restricted and numbness in right pointer finger. Right leg felt restricted and pain behind the knee. Day 3- dizzy, dull headache, faint, high blood pressure, right arm & leg and left arm felt restricted and numbness/tingling in right hand. Pain behind right knee persisted. Went to ER Sunday early afternoon. Diagnosis is a cerebral venous thrombosis in sinus cavity. Still experiencing general weakness/tired, dizzy/unbalanced.


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