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

This is VAERS ID 1248557



Case Details

VAERS ID: 1248557 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Disturbance in attention, Headache, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament 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: METROPOLOL, VIT-D, VIT-C, ZINC
Current Illness: FIBROMYALGIA, IRREGULAR HEAT BEAT
Preexisting Conditions: FIBROMYALGIA, IRREGULAR HEAT BEAT
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient discribed mild headache immediately after. Patient experienced sore arm for about 10 days. Patient started experiencing pain all over a week after the injection. she describes it as a burning sensation though her nervous system and joint pain. Patient also experienced a brain fog a week after her injection. She states that she has trouble putting her thoughts to words. She still feel this reactions on your 17th day.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1248557


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