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

This is VAERS ID 1230196



Case Details

VAERS ID: 1230196 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-20
Onset:2021-04-11
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Thrombophlebitis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Clindamycin, Crestor, Tri Femynor (birth control)
Current Illness: None
Preexisting Conditions: Hyperlipidemia, long QT syndrome and Attention deficit disorder
Allergies: NKDA
Diagnostic Lab Data: U/S 4/19/21
CDC Split Type:

Write-up: pt had left upper arm pain and found on ultrasound 4/19/21 to have a superficial thrombophlebitis


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230196


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