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

This is VAERS ID 1249875



Case Details

VAERS ID: 1249875 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Feeding disorder, Headache, Heavy menstrual bleeding, Muscle spasms, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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: Venafalaxen 300mg, Propranolol 10mg, Topirimate 100mg, methylphenidate er 20mg, prazosin 4mg, citrezine 10mg.
Current Illness: Allergies
Preexisting Conditions: H.S., Migraines, seasonal allergies, Chronic back pain, asthma, CPTSD, Depression, Anxiety, ADHD, and BPD.
Allergies: Latex, grapefruit, doxycycline.
Diagnostic Lab Data: I have an appointment with a new physician in May but couldn?t get in any sooner.
CDC Split Type:

Write-up: Severe headache that lasted several days, extremely heavy period. Soaking overnight pads every fifteen - twenty minutes for three days while still leaking and dripping blood everywhere. Extreme cramps that I would rate at a 10/10 in pain. Absolutely debilitating. Day four has been soaking overnight pads at a slower rate but still less than an hour per pad. Diarrhea, nausea and vomiting. Unable to keep food down but able to keep water down. No fever.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1249875


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