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

This is VAERS ID 1228343



Case Details

VAERS ID: 1228343 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-04
Onset:2021-04-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Glossodynia, Head discomfort, Headache, Muscle spasms
SMQs:, Taste and smell disorders (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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: None
Allergies: None
Diagnostic Lab Data: Patient contacted State hotline number and was asked to fill out this report by State Nurse who also recommended patient follow up with PCP.
CDC Split Type:

Write-up: Leg cramps pain especially at night. Worst with left leg. Headache and feeling heavy headedness. Lost of taste and small cramps on light side of tongue.


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