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

This is VAERS ID 1244852



Case Details

VAERS ID: 1244852 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Maryland  
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 - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue, Headache, Injection site pain, Insomnia, Malaise, Mouth ulceration, Nausea, Oropharyngeal pain, Pyrexia, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Metoprolol succinate 50mg, Amlodipine 5mg Vitamin D soft gel 1 (125 mcg)
Current Illness: None
Preexisting Conditions: Benign HBP under control with meds
Allergies: Penicillin injection Raw ripe tomatoes Camoquin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After vaccination on April 12 had nausea and vomiting, chills and headache, stomachache most of the day. At night had fever, pain at injection site, malaise. Same on day2 but milder and headache. Insomnia Day 3 -7chills at day and night time mild headache, sore throat, insomnia Day 7 nausea, chills and headache, tiredness, sorethroat, insomnia Day 8- 10 chills, mouth sores, tiredness, insomnia On eAch day took antihistamine cetrizine


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1244852


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