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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1212121



Case Details

VAERS ID: 1212121 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Menstrual disorder, Nausea, Pain, Seizure
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Nausea-Medium, Systemic: Seizure-Medium, Additional Details: patient was taken to er after having a seizure. patient has been feeling sick ever since injection and has missed her period. The physicians at the Emergency room said they could not find anything wrong with her. But mother is convinced something is not right. she is seeking a second opinion from different hospital


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212121

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