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

This is VAERS ID 1347630

Case Details

VAERS ID: 1347630 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Headache, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1952 reaction to small pox vaccine, high fever and seizures at just over a year old.
Other Medications: Diltiazam, Hydroxychloroquine, Vitamin D3
Current Illness:
Preexisting Conditions: Sjogren''s, High blood pressure
Allergies: Sulsa, Penicillin, Cipro, Flagyl, Clindamycin, Bactrim, Septra, Cotrim, Terbinafine, Valsartan, Doxycycline Hyalite, Norvasc, Hydrochlorothiazide
Diagnostic Lab Data: CT scan for nerve issue, nothing found
CDC Split Type: vsafe

Write-up: Headache on my left side for a few weeks, Left arm still aches, sharp nerve issue

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