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

This is VAERS ID 1242996



Case Details

VAERS ID: 1242996 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-04-19
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: EUTHROX, FERGON, FLUTICASONE, OMEPRAZOLE, SUMATRIPTAN, TOPIRAMATE
Current Illness: NONE
Preexisting Conditions: ANEMIA, GERD, HYPERLIPIDEMIA, HYPOTHYROIDIMS, NICOTINE DEPENDENCE, TMJ
Allergies: AMOXICILLIN, PENICILLIN
Diagnostic Lab Data: SARS-CoV-2 RNA DETECTED - PCR TEST RUN AT CLINIC
CDC Split Type:

Write-up: VACCINE BREAKTHROUGH CASE


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