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

This is VAERS ID 1230716



Case Details

VAERS ID: 1230716 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Dizziness, Muscular weakness, Nausea, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210411; Test Name: Body temperature; Result Unstructured Data: 102 F
CDC Split Type: USJNJFOC20210422929

Write-up: SEVERE ACHES; SORE THROAT; DIZZINESS; MUSCLE WEAKNESS; CHILLS; NAUSEA; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On 11-APR-2021, the subject experienced severe aches. On 11-APR-2021, the subject experienced sore throat. On 11-APR-2021, the subject experienced dizziness. On 11-APR-2021, the subject experienced muscle weakness. On 11-APR-2021, the subject experienced chills. On 11-APR-2021, the subject experienced nausea. On 11-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 102 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the severe aches, muscle weakness, nausea, dizziness, chills, sore throat and fever was not reported. This report was non-serious.


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