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

This is VAERS ID 1251601



Case Details

VAERS ID: 1251601 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Asthenia, Back pain, Blood pressure increased, Decreased appetite, Diplopia, Disorientation, Dizziness, Feeling abnormal, Metabolic function test, Muscle tightness, Pain in extremity, Pelvic pain, Peripheral swelling, Thirst, Urine analysis abnormal
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Ocular motility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: fibrosis caused by exposure to injected gadolinium-based contrast dye
Preexisting Conditions: gadolinium deposition disease, tachycardia
Allergies: yes, antibiotics, penicillins, MRI contrast dyes
Diagnostic Lab Data: Saw Dr at urgent Care where a Comprehensive metabolic was done. I hope to attach the results. On April 18th When I was with Dr. I had dizziness and disorientation and again on the April 20th along with a spike in blood pressure.
CDC Split Type:

Write-up: got it April 10th First day fine, second-day urine dark, third-day fog and disoriented sensation in my head and double vision, and periods of weakness in hands (now coming and going), lack of appetite, extreme thirst, no fever, no vomiting, pains in my thighs and stomach, middle back pain, Hips, pelvis, 9th day: calves so painful and tight I could not get out of bed, figures swelled up to the point that I could not put on my finds, 10th day my calves are very painful (like the soreness that is felt after someone punches you) Especially right calf. The batch number is 206a21a if I can read it from my card.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251601


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