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

This is VAERS ID 1229980



Case Details

VAERS ID: 1229980 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Cough, Dizziness, Fatigue, Headache, Nausea, Platelet count normal, Pyrexia, Retching, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin c Vitamin d B12
Current Illness: None
Preexisting Conditions: Low whit blood count but deemed as normal for me
Allergies: Epi
Diagnostic Lab Data: Had Covid shot on Sunday. Went to see my doctor on Thursday he said my platelets were fine and everything was OK after doing blood test. I still have a slight headache a few aches in my legs and arm
CDC Split Type:

Write-up: Shaking chills, fever of 103 for 12 hours then 102 rest of day until 8pm Monday night. Dry heaves, coughing, massive headache, weakness, fatigue, dizziness, nausea thought I was going to die, like I had an Aneurysm or like menengitus, arm hurt.


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