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

This is VAERS ID 1237265



Case Details

VAERS ID: 1237265 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-04-19
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache, Lethargy
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Slight hives with Penecillin 60 years ago.
Other Medications: Hydro chlorothiazide Atorvastatin
Current Illness: None
Preexisting Conditions: None other than a heart murmur
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills and lethargy on Monday - slept all day. Moderate chills and slight headache on right rear in the morning on Tuesday. A little lasting lethargy today.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1237265


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