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

This is VAERS ID 1261180



Case Details

VAERS ID: 1261180 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Headache, Nausea, Neck pain, Pain, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (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:
Current Illness: Dependence on opiates; Depression; Hepatitis C; HIV infection; Penicillin allergy; Polysubstance abuse
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210425865

Write-up: SYNCOPE EPISODE; NECK PAIN; LOSS OF APPETITE; BODY ACHE; DIZZINESS; VOMITING; CHILLS; HEADACHE; NAUSEA; This spontaneous report received from a health care professional concerned a 32 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included penicillin allergy, hepatitis C, HIV, opioid dependence, polysubstance abuse, and depression. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805025, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021 about one hour after the vaccination, the patient experienced neck pain, loss of appetite, body ache, dizziness, vomiting, chills, headache, and nausea. On 13-APR-2021, the patient experienced syncope episode and other symptoms got worsened. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from syncope episode, chills, neck pain, loss of appetite, headache, nausea, vomiting, body ache, and dizziness. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked.; Sender''s Comments: V0- covid-19 vaccine ad26.cov2.s-syncope. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE


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