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

This is VAERS ID 1248330



Case Details

VAERS ID: 1248330 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-09
Onset:2021-04-19
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 5 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: chronic
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient has leg cramps starting on Monday, April 19th. She went to the hospital at later date. Doctor diagnosed her with leg clot.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1248330


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