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

This is VAERS ID 1233325



Case Details

VAERS ID: 1233325 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Diarrhoea, Dyspnoea, Fatigue, Fibrin D dimer, Headache, Laboratory test, Oral mucosal eruption, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Seasonal allergies, sea food, shellfish, spicy food, latex, Polyethylene Glycol in miralax
Diagnostic Lab Data: blood tests, D- dimme test
CDC Split Type: vsafe

Write-up: Within 15 minutes of receiving my J&J vaccine, I experienced diarrhea. 12 hours later I ran a temperature of 37.5 and also had chills. On Sunday morning 04-11-2021, I had horribleheadaches and I took a Tylenol but it did not help. On Monday, Tuesday and Wednesday I again woke up with headaches and I felt extremely fatigued. I went to see my PCP who performed blood tests and also did a D-dimme test which the tests came back as being okay. I also experienced a full body rash and was having slight breathing issues. I also went to see an allergist on Monday 04-12-2021 due to my whole body rash, patchy skin, red and white bumps on my forehead. I was also concerned because at the inside of my mouth and upper pallet I had red bumps which lasted three days. I took me a whole week to recover from these symptoms.


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