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

This is VAERS ID 1223831



Case Details

VAERS ID: 1223831 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A71A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cerebral haematoma, Cerebral haemorrhage, Fatigue, Headache, Hypoaesthesia, Intensive care, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vit d 3 Levothyroxine amoxicillin
Current Illness: toothache (was on antibiotic)
Preexisting Conditions: Hypothyroidism
Allergies: chloroquine
Diagnostic Lab Data: BRAIN BLEED (HEMATOMA) LOW PLATELETS CURRENTLY IN ICU SINCE 4/13/21
CDC Split Type:

Write-up: SEVERE HEADACHES, LEG NUMBNESS, CHRONIC FATIQUE SYMPTOMS STARTED WITHIN 24HRS AND PROGRESSED


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