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

This is VAERS ID 1261432



Case Details

VAERS ID: 1261432 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain lower, Back pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Thyroid disorder
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448255

Write-up: LOWER ABDOMINAL PAIN; BACK PAIN; BODY PAIN; RIGHT LEG PAIN; FEVER; This spontaneous report received from a patient concerned a 36 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included thyroid problems, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced body pain. On 11-APR-2021, the subject experienced right leg pain. On 11-APR-2021, the subject experienced fever. On 19-APR-2021, the subject experienced back pain. On 22-APR-2021, the subject experienced lower abdominal pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body pain, right leg pain, and fever on 12-APR-2021, and had not recovered from back pain, and lower abdominal pain. This report was non-serious.


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