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

This is VAERS ID 1225273

Case Details

VAERS ID: 1225273 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Depression, Dizziness
SMQs:, Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Arthritis (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing 12 hours before shot, but I do take a multiple vitamin, Vitamin D and B12.
Current Illness: Crohn''s disease
Preexisting Conditions: Crohn''s disease
Allergies: tetracycline, codeine, sulfa products.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Worsening depression and anxiety; dizziness; joint pain.

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