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

This is VAERS ID 1273941

Case Details

VAERS ID: 1273941 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Iowa  
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Laboratory test, Magnetic resonance imaging, Magnetic resonance imaging head, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: ASA 81mg po, Glucosamine Sulfate 1000mg , Vit D3, Clonazepam 0.5mg , Bupropion HCI 150mg , Empagliflozin 25mg , Glyburide 5mg BID, HCTZ 25mg , Indomethacin 50mg TID, Fish oil, Lisinopril 40mg, Loratadine 10mg , Metformin 1000mg bid, Metopro
Current Illness: none
Preexisting Conditions: Type II DM, cold sores, sleep apnea, MI 2005, Vit D, Ischemic heart DZ, elevated LFTs, GERD, Depression with anxiety, ED, Dyslipidemia, Gout, Hydrocele, Inguinal Hernia,
Allergies: Augmentin and morphine
Diagnostic Lab Data: MRV and MRI of the brain, labs, NS 1000mg bolus, and Decadron 10mg IVP,
CDC Split Type:

Write-up: H/A, Nausea, vomited x1, lightheaded

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