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

This is VAERS ID 1262096

Case Details

VAERS ID: 1262096 (history)  
Form: Version 2.0  
Sex: Female  
Location: Texas  
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Blood pressure decreased, Chest discomfort, Dizziness, Dysphonia, Dyspnoea, Fatigue, Feeling hot, Headache, Oropharyngeal pain, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427636

Write-up: BLOOD PRESSURE DROPPED; HEADACHE; FATIGUE; BODY PAIN; BACK PAIN LIKE WHERE MY LUNG IS; IT HURTS WHEN I BREATHE; SWELLING OF MY FEET; VOICE CHANGES; DIZZINESS; HOT FEELING IN FEET; FELT LIKE CHEST WAS ACCELARATING; THROAT PAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021, the subject experienced blood pressure dropped. On an unspecified date, the subject experienced body pain, back pain like where my lung is, it hurts when i breathe, swelling of my feet, voice changes, dizziness, hot feeling in feet, felt like chest was accelarating, throat pain, headache, and fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt like chest was accelarating, and headache, and the outcome of body pain, back pain like where my lung is, it hurts when i breathe, swelling of my feet, voice changes, fatigue, dizziness, hot feeling in feet, throat pain and blood pressure dropped was not reported. This report was non-serious.

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