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

This is VAERS ID 1237372



Case Details

VAERS ID: 1237372 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-04-19
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808975 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: Trulicity; Metformin; Atorvastatin; Zyrtec; ASA; MVI; Tamsulosin
Current Illness: No
Preexisting Conditions: Diabetes
Allergies: PCN
Diagnostic Lab Data: Covid Naso Pharyngeal swab Positive
CDC Split Type:

Write-up: Diagnosed with Covid on 4/20/2021, more than 2 weeks after receiving


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