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

This is VAERS ID 1331290



Case Details

VAERS ID: 1331290 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Feeling hot, Hyperhidrosis, Nervousness, Photopsia, Retching, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient was very nervous about getting the covid vaccine. She sat for 15 minutes and after about 8 minutes she said she thought she was having a panic attack and felt hot. Tech administered vaccine and sat with her the whole wait time since she was nervous. Held an ice pack on her neck when she stated she felt hot. The 15 minute timer went off and she still felt nervous so she continued to sit. Rph also was present once the ice pack was given. She had a dry heave at about 12 minutes. After 20 minutes we moved her to the floor she said she was seeing light flashes. She was sweaty and hot. BP was taken at 420pm 162/109 and 98 pulse. Asked pt if we could call an ambulance, she felt she didn''t need one. We got lead from Division 1, also suggested an ambulance and this time pt said ok. Now BP taken was 157/109 and pulse 108. Patient felt a dry heave and we put her on her side. Ambulance arrived and put pt on a stretcher.


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