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

This is VAERS ID 1251762



Case Details

VAERS ID: 1251762 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-04-12
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Cognitive disorder, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Magnetic resonance imaging normal, Nausea, SARS-CoV-2 test negative, Speech disorder, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (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), Vestibular disorders (narrow), COVID-19 (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: Levothyroxine 5 mcg 2x week Levothyroxine 75 mcg 5x week Liothyronine 5 mcg 1x daily Clindamycin Phosphate & Benzyne Peroxide Gel 1.2%/5% 1x daily morning Tretinoin Cream USP 0.1% 1x daily evening Claritin Ready Tabs 1x daily as needed Niac
Current Illness: none
Preexisting Conditions: Hypothyroid
Allergies: Indocin, Acacia pollen. Occasional itchiness with avocado, pork, shrimp, and lobster.
Diagnostic Lab Data: April 14 - COVID19 negative, requested MRI of brain. EKG normal. April 16 - COVID19 negative, requested MRI of brain. EKG normal. Stroke negative, CT scan, MRI of brain all normal.
CDC Split Type:

Write-up: Date of injection: swelling, redness, soreness and itchy around injection site that continued for a week. April 12 Unexplained symptoms. Woke with throbbing head, light headed, off balance, impaired cognitive functions, impaired speech and random mild nausea that continued through mid-day April 13. Throbbing head and dizziness all dissipated when sitting or lying down. Visited Doctor on April 14 and ruled out stroke, heart attack and tested negative for COVID19. Symptoms lessened but did not disappear and visited hospital where they again ruled out stroke, heart attack and tested negative for COVID19. Performed Catscan and MRI of the brain that all showed normal. Performed inner ear testing that was normal, although they said I appeared to be experiencing some vertigo. April 23 still experiencing mild speech impairment and tire after talking for more than 10 minutes. Cognitive abilities inhibited by ongoing focus issues and search for right words. Balance issues easily impacted vigorous head movement.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251762


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