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

This is VAERS ID 1271589



Case Details

VAERS ID: 1271589 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Disseminated varicella zoster virus infection, Herpes virus infection
SMQs:, Sepsis (broad), Opportunistic infections (narrow)

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: Valtrex, gabapentin, levothyroid
Current Illness: HYPOTHYROIDISM HYPERLIPIDEMIA HX OF TOTAL HYSTERECTOMY SCREENING FOR COLORECTAL CANCER, AVERAGE RISK DECLINES VACCINATION DECLINES MAMMOGRAM SCREENING DISSEMINATED HERPES ZOSTER
Preexisting Conditions:
Allergies: Sulfur
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt developed a disseminated Zoster-kin lesions on 4/21


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