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

This is VAERS ID 1378250

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Case Details

VAERS ID: 1378250 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-03
Onset:2021-06-02
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Cough, Eye disorder, Neurological symptom
SMQs:, Anaphylactic reaction (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (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: none
Current Illness:
Preexisting Conditions: coronary artery disease-ongoing but function just fine-just hereditary
Allergies: hydralazine & statins
Diagnostic Lab Data: went to my urgent care on 6/4 and they diagnosed the bells palsey, gave me prednazone and an antibiotics
CDC Split Type:

Write-up: bells palsey - severe issue in left eye and left side; minor chest cough I didn''t have before


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