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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1251844

Case Details

VAERS ID: 1251844 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New York  
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid, Cerebrovascular accident, Chest X-ray, Computerised tomogram head abnormal, Echocardiogram, Electrocardiogram, Glycosylated haemoglobin, Laboratory test, Lipids, Magnetic resonance imaging head abnormal, Magnetic resonance imaging neck, Saline infusion sonogram
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA 81 mg, Brilinta 90 mg, Altace 5 mg, crestor 40 mg, lopressor tartrate 25 mg , vit C, calcium, saw palmetto, flomax, b6-mag
Current Illness: Non-ST elevation MI February 19, 2021
Preexisting Conditions: Underlying coronary artery disease, hypertension, hyperlipidemia, BPH, history of prostate cancer
Allergies: Penicillin - hives and Lovenox - rash
Diagnostic Lab Data: Hospital admission, head CT, EKG, chest x-ray, lab work, A1c, lipid profile, MRI/MRA brain/head/neck, transthoracic echocardiogram with bubble study
CDC Split Type:

Write-up: acute CVA

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