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

This is VAERS ID 1243086



Case Details

VAERS ID: 1243086 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Condition aggravated, Fatigue, Headache, Heavy menstrual bleeding, Lethargy, Menstruation irregular, Nasal congestion, Nasopharyngitis, Nausea, Vaginal haemorrhage, Vascular pain
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Hypoglycaemia (broad)

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: 5HTP, iron supplement, vitamin D, B12 complex, Ashawaganda
Current Illness: No
Preexisting Conditions: Varicose Veins
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache for two days. Extreme chills, nausea, cold sweats, fatigue for three days. On the third day previous symptoms went away and I got an extreme head cold, congestion, tiredness, lethargic. My varicose veins have been midly painful but it might be from laying all day for a week. On day five I started my menstrual cycle two weeks early, it was completely black and clumpy (not normal). It is now day 10 and I still have a slight cold, very tired, and am still on my period.


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