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

This is VAERS ID 1269137



Case Details

VAERS ID: 1269137 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acoustic stimulation tests, Body temperature, Fatigue, Pyrexia, SARS-CoV-2 test negative, Therapeutic response unexpected
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hearing aid user
Preexisting Conditions: Medical History/Concurrent Conditions: Ear infection; Sensorineural hearing loss; Tinnitus
Allergies:
Diagnostic Lab Data: Test Date: 20210411; Test Name: Body temperature; Result Unstructured Data: 101.8 F; Test Name: Hearing test; Result Unstructured Data: Unknown; Comments: gets annual hearing tests; Test Name: COVID-19 virus test negative; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210437919

Write-up: TIREDNESS; UNEXPECTED THERAPEUTIC BENEFIT; FEVER; This spontaneous report received from a patient concerned a 57 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included sensory neural hearing loss, tinnitus, and inner ear sepsis, and concurrent conditions included hearing aid user. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.8 F. On 12-APR-2021, the subject experienced unexpected therapeutic benefit. On 14-APR-2021, the subject experienced tiredness. Laboratory data (dates unspecified) included: COVID-19 virus test negative (NR: not provided) Negative, and Hearing test (NR: not provided) Unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 12-APR-2021, was recovering from tiredness, and the outcome of unexpected therapeutic benefit was not reported. This report was non-serious.; Sender''s Comments: V1: Medical Assessment Comment not required as per standard procedure as case assessed as Non serious.


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