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

This is VAERS ID 1222152



Case Details

VAERS ID: 1222152 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: None
Current Illness: None
Preexisting Conditions: N/A
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient''s husband called about reactions after the vaccine as patient does not speak english. She experiencing trouble breathing for the whole week and feels very tired. Also reports swelling and pain in the legs and hand, significant enough to prevent her from removing her wedding ring. I recommended them to go to the emergency room as soon as possible as her symtoms resemble a possible clot. She does not have a PCP to refer her to nor does she has insurance. He agrees to take her to the emergency room.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1222152


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