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

This is VAERS ID 1346719



Case Details

VAERS ID: 1346719 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram normal, Facial paralysis, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (narrow), Hearing impairment (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: aspirin 81 mg daily acetaminophen as needed betamethasone valerate lotion carvedilol 12.5 mg daily cholecalciferol 1000 units daily docusate 200mg daily ferrous sulfate 325mg daily glimepiride 2mg daily levemir 6 units daily melatonin 3
Current Illness:
Preexisting Conditions: psoriasis anemia constipation type 2 Diabetes Mellitus CAD A fib COPD CHF
Allergies: codeine dexlansoprazole erythromycin penicillin demerol robitussin-DM Zemuron Zithromax
Diagnostic Lab Data: CT scan negative on 5/22/21
CDC Split Type:

Write-up: headache elevated blood pressure left eye drooping


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1346719


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