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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1327790



Case Details

VAERS ID: 1327790 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling cold, Feeling hot, Hyperhidrosis, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: no know drug allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt had vasovagal syncope, dizzy, passed out, sweating, hot and cold. 911 was called. Put ice on pt''s neck, spoke to pt to keep awake, blood pressure taken, EMS took all vitals and blood sugar and EKG all normal. pt allowed to leave pharmacy with ride home from girlfriend. followed up with pt 1 hour later by phone, pt is feeling ok but tired.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1327790


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