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

This is VAERS ID 1212804



Case Details

VAERS ID: 1212804 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Skin burning sensation
SMQs:, Peripheral neuropathy (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:
Current Illness:
Preexisting Conditions:
Allergies: SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: ALOPECIA RESULTING IN COMPLETE HAIR LOSS ON HEAD OCCURRING APPROXIMATELY 4 DAYS AFTER RECEIVING THE VACCINE. PATIENT ALSO REPORTS BURNING SENSATION ON SCALP.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212804

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