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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1354780

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Case Details

VAERS ID: 1354780 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Throat irritation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 42-year-old female with history of bipolar disorder presents with allergic reaction. Patient states she received the Johnson and Johnson vaccine and subsequently developed itching and scratchiness in her throat on 4/11/21 and developed hives. Felt as though throat was closing. . Denied ever having any shortness of breath or difficulty breathing. Patient was given steroids epinephrine and Benadryl and transported to the hospital. Proceeded to ED and given Epi 0.5mg and Benadryl 50 mg PTA. Discharged and instructed to go to ED if ASAP if develop new/worsening symptoms and follow-up with PCP within next 24-48 hours. Patient denies any complaints at this time. States she never had a rash and denies any shortness of breath difficulty breathing. Denies any chest pain. Denies abdominal pain nausea vomiting or diarrhea and denies any urinary symptoms including urgency frequency or dysuria.


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