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

This is VAERS ID 1251493



Case Details

VAERS ID: 1251493 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-11
Onset:2021-04-11
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Ischaemic stroke, Loss of consciousness, Magnetic resonance imaging head abnormal, Visual field defect, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Biotin, Calcium supplement, Celebrex, Fish oil supplement, OXcarbazepine, Vitamin C & D3 supplements
Current Illness: None
Preexisting Conditions: Post neuropathic Shingles
Allergies: None
Diagnostic Lab Data: CT Scan & MRI indicated partial blockage leading to unconsciousness and stroke
CDC Split Type:

Write-up: Ischemic Stroke requiring hospitalization. Significant reduction in field of vision. Loss of nearly all Left Side peripheral vision


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251493


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