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

This is VAERS ID 1231141



Case Details

VAERS ID: 1231141 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERAL
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NUTS
Diagnostic Lab Data: PLEASE SEE ATTACHED DOCTORS NOTES AND TESTS RESULTS
CDC Split Type:

Write-up: PLEASE SEE ATTACHED DOCTORS NOTES AND TEST RESULTS


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1231141


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