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

This is VAERS ID 1249408



Case Details

VAERS ID: 1249408 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Nausea, Polymerase chain reaction, Suspected COVID-19, Taste disorder
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: PCR; Result Unstructured Data: Negative (unit unspecified)
CDC Split Type: USJNJFOC20210438020

Write-up: COVID SYMPTOMS; CHILLS; NAUSEA; TASTE SENSATION; LIGHTHEADEDNESS; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: PCR (NR: not provided) Negative (unit unspecified). On 11-APR-2021, the subject experienced taste sensation. On 11-APR-2021, the subject experienced lightheadedness. On 11-APR-2021, the subject experienced chills. On 11-APR-2021, the subject experienced nausea. On 19-APR-2021, the subject experienced covid symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from taste sensation, and chills, was recovering from lightheadedness, and covid symptoms, and had not recovered from nausea. This report was non-serious.


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