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

This is VAERS ID 1274411



Case Details

VAERS ID: 1274411 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray abnormal, Dyspnoea, Fibrin D dimer increased, Full blood count abnormal, Headache, Metabolic function test abnormal, Pain, Pneumonia, Pyrexia, Reaction to previous exposure to any vaccine, SARS-CoV-2 test negative, Scan with contrast abnormal, Sepsis, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Flu vaccine
Other Medications: Baclofen, hydrocodone, gabapentin, xanax, Levequin, steroids, crestor, seriquel,
Current Illness: Sinus infection, osteoarthritis, bulging disk in lower disk.
Preexisting Conditions: Goodpasture''s syndrome Lung disease Osteoarthritis Degenerative disk disease Heart palpitations/enlarged heart High blood pressure History of pre cancerous colon polyps.
Allergies: Flu vaccines, all nsaids that contain ibuprofen and aspirin, milk products, oxycodone, certain antibiotics like amoxocillen, latex.
Diagnostic Lab Data: CAT scan, x-ray of chest= pneumonia see above, cbc, metabolic blood work= horrible results for someonethat is normallyhealthy, see above, covid testing 3-4 times= negative on each one
CDC Split Type:

Write-up: Started with a fever, on day 3 fever was higher and I was short of breath as well as wheezing. On Thursday the 15th I went to the dr. The x-ray didn''t show anything however my cbc was of concern and she also did a d timer. It came back elevated, so she sent me over for a CAT scan with contrast. It showed pneumonia in my upper and lower right lung and also my lower left lung. She sent me home to try and treat it there. Over the weekend I felt worse and my husband took me to the ER. Upon arrival my blood pressure was 160 over 120 and heart rate was 140. They admitted me to the hospital for treatment of sepsis and pneumonia and pain management. I was there for 4 days. I was released on the 22nd of April and I am still feeling all of these effects on my body. Headache that I have not been able to get rid of even with the help of prescription medication.


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