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

This is VAERS ID 1259705



Case Details

VAERS ID: 1259705 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 201A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Induration, Injection site haemorrhage, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Amnestic MCI
Allergies: Codiene, seafood, Clinimyicine
Diagnostic Lab Data: Follow up with doctor 4/26. Steroid shot and strong antibiotics given
CDC Split Type:

Write-up: Extreme swelling 2 weeks after vaccine. A lot of bruising. Left hard very sore size of quarter place on right arm. Blood a lot when injection was done.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1259705


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