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

This is VAERS ID 1243073



Case Details

VAERS ID: 1243073 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Neck pain, Sleep disorder
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen Apixaban Diltiazem Lisinopril Metoprolol Rosuvastatin Vitamin D3 Travoprost ophthalmic drops Furosemide Fish Oil Potassium Tramadol
Current Illness: None
Preexisting Conditions: Afib, HTN, prostate CA, and glaucoma.
Allergies: No known medication or food allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has been having severe neck pain (b/l right below ears) and severe bilateral shoulder pain since 04/12/21 (the day after his Johnson and Johnson COVID vaccine). Patient has been unable to sleep due to the severe pain. Patient was given some PO pain medication from his PCP and has not been able to get any relief.


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