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

This is VAERS ID 1249541

Case Details

VAERS ID: 1249541 (history)  
Form: Version 2.0  
Sex: Unknown  
Location: Kentucky  
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Feeling jittery, Headache, Insomnia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness: Drug allergy; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210443879

Write-up: SORENESS; JITTERINESS; UNABLE TO SLEEP; FATIGUE; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 71 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy, and codeine allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced soreness. On 12-APR-2021, the subject experienced jitteriness. On 12-APR-2021, the subject experienced unable to sleep. On 12-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from jitteriness, unable to sleep, and fever on 13-APR-2021, fatigue on 14-APR-2021, and headache on 15-APR-2021, and was recovering from soreness. This report was non-serious.

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