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

This is VAERS ID 1258372



Case Details

VAERS ID: 1258372 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Blood test, Chest X-ray, Culture urine, Differential white blood cell count, Full blood count, Microtia, Parasite DNA test, Parasite blood test, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Ropinirole, Clonazapem, Hydrochlorothiazide, Levothyroxine, Zyrtec, Folic Acid, B12, calcium, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Kiwi Fruit, Avalox, Doxycycline, Erthromycin, Penicillan, Sulfides
Diagnostic Lab Data: 4/15: COVID Test 4/16: Initial visit to Urgent Care - prescribed Z-Pack 4/20: Second visit to Urgent Care: Chest X-Ray, Urine Culture, Blood work for , LYME IGG/IGM, BABESIA DNA, BABESIA MICROTI DNA, ANAPL PHAG DNA, CBC Differential, Parasites - Blood
CDC Split Type:

Write-up: Fever of 102.5 on 4/13, fever of 101.3 on 4/14, fever of 103.6 on 4/15.


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