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

This is VAERS ID 1375971



Case Details

VAERS ID: 1375971 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Hypersensitivity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Other Medications: I takeatorvastatin and a multivitamin.
Current Illness: None
Preexisting Conditions: Foot problems
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: By the evening on the day of the shot I noticed my arm getting red and swollen. It continued swelling until I went to the doctor today June 4th. He said I was having an allergic reaction and to take Benadryl. Started Benadryl at 4:45 this evening.


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