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

This is VAERS ID 1377321

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Case Details

VAERS ID: 1377321 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Fatigue, Headache, Pain, Pain in extremity, Vaccination site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Tendinopathies and ligament disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pcp referred her to our hotline for triage. Recommended pt go to Urgent Care asap for w/u and to f/u with her pcp.
CDC Split Type:

Write-up: Pt developed sore arm, Tmax to 102, fatigue and headache ~5 hours post vax, but these symptoms mostly improved within 24 hours. Vax site swelling (Left arm) increased to size of palm of hand and developed pain shooting down legs (R$gL) over the next few days. Today is 5 days post vax.


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