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

This is VAERS ID 1247080



Case Details

VAERS ID: 1247080 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Herpes zoster, Rash, Rash pruritic, Skin burning sensation, X-ray
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: 100mg sertraline 2 mg lorazepam 40 mg omeprazole 25 mg hydrochlorathiazide 5 mg glipizide
Current Illness: None
Preexisting Conditions: Chronic ear infections Type 2 diabetes Hypertension Depression Anxiety ADHD Non alcoholic fatty liver disease Arthritis Urinary in continuance
Allergies: Tramadol Dogs Seasonal Penicillin Chantix Cymbalta
Diagnostic Lab Data: Labs, ct scan, X-ray during er visit and external exam at both Er and office visit
CDC Split Type:

Write-up: Shingles, I?m on day 4, treatment is anti viral med and nerve pain med. I have a large patch of painful itchy bumps under my left shoulder blade and it is spreading to my left side and under my left breast. It burns on the skin and internally feels like someone is squeezing my kidney and spine.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247080


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