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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1368846



Case Details

VAERS ID: 1368846 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Insomnia, Pain in extremity, Product storage error
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: Best use date recorded by HD as 3 months from receiving. Received on 3-2-2021. Marked to discontinue use on 6-2-2021. Maintained in cold chain management 36 to 46 degrees F. Administered on 6-1-2021 Vial opened for the client. The other 4 doses were discarded at the end of the clinic. On 6-2-2021 an e-mail from DH was noted with expiration of Lot 1802068 on 5-25-2021. Johnson & Johnson was contacted and reported to Pharmacist. Reference ID EZR20210078918(VO) case # 02242111. Client has a Developmental Disability. His guardian (mother) was contacted expiration date reported. The mother states that client c/o sore arm 6-1 with difficulty sleeping. Today he is feeling back to normal. No problems or concerns.


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