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

This is VAERS ID 1230142



Case Details

VAERS ID: 1230142 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
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 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Blood test, Dizziness, Fatigue, Headache, Hyperhidrosis, Injection site discomfort, Injection site erythema, Injection site pain, Injection site swelling, Limb discomfort, Local reaction, Magnetic resonance imaging, Magnetic resonance imaging head, Migraine, Neuralgia, Pain, Paraesthesia, Pyrexia, Ultrasound scan, Urinary tract infection, Urine analysis
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol.05, Progesterone 100mg, magnesium, zinc, Vit D, mult
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: ultra sound on arm - result negative for blood clot. 3 days later, ER did blood, urine and MRI on brain and veins and no clot but did have a UTI without any symptoms.
CDC Split Type:

Write-up: 5 minutes after injection my forearm and hand began to tingle and have pressure, nerve type pain. No breathing issues so was sent home. Reported the continued arm pain the next day to the doctor and she ordered an ultrasound. Report negative on blood arm clot. Got a fever, body aches, headache, tired, triggered a migraine per doctor, localized reaction of 2 3/4" at injection site with redness, swelling, pain. Almost passed out at a store - Became dizzy, tingling hands and sweating and taken to ER by ambulance. ER ruled out blood clot but found I had a UTI without any symptoms-prescribed an antibiotic. Contiue to have minor headache and minor discomfort at injection site. Awful experience and adverse reactions!


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230142


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