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

This is VAERS ID 1213025



Case Details

VAERS ID: 1213025 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Ear pain, Electrocardiogram, Head discomfort, Headache, Muscular weakness, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Tramadol, Methylene Blue, Ketotifen oral capsule
Current Illness: no active illness at time of vaccine
Preexisting Conditions: Lyme disease, possible MS, neuropathy, chronic pain syndrome, chronic fatigue syndrome, chronic headaches/migraines
Allergies: Sulfa drugs, Codeine, Prednisone, Latex
Diagnostic Lab Data: Neuro exam, 2vw chest radiograph, Urinalysis, EKG (all done at urgent care 4/14/21)
CDC Split Type:

Write-up: Atypical Headache 8 days post J&J vaccine. Woke up with headache at 7:30am and the headache got progressively worse throughout the day. Headache symptoms included head pressure, ear pain, and generalized full body weakness. Went to urgent care at 6:00pm. Due to ongoing health issues it was hard for the doctor to tell if it was a reaction to the vaccine or not at the time of exam. The doctor discharged me and recommend I go to ER if symptoms progress/get worse.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1213025

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