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

This is VAERS ID 1333240



Case Details

VAERS ID: 1333240 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Full blood count, Inflammation, Metabolic function test, Myalgia, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: asa, azelastine, cialsis, testosterone, propranolol, b-complex, zinc, copper
Current Illness: none
Preexisting Conditions: htn.
Allergies: none
Diagnostic Lab Data: cmp, cbc, ua (all done at the er)
CDC Split Type:

Write-up: beginning on 05/04/21 developed severe and disabling polymyalgia and poly arthralgia : was seen at urgent care twice and a local er once. we all agree this is likely an autoimmune inflammatory response to the vaccine. the patient has been placed on steroids with good response and pain reduction.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1333240


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