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

This is VAERS ID 1382954

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Case Details

VAERS ID: 1382954 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808882 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Dizziness, Eye pain, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular 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: None
Current Illness: High blood pressure
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Blood clot test, and Radiologic chest exam 4/13/21 at hospital. VNG and audio gram ENT 5/17/21 VHIT & VEMP scheduled for 6/15/21 at ENT. Neurology scheduled for September 2021
CDC Split Type:

Write-up: Had fever chills head ache a dizziness start evening after shot. Fever chills only lasted 2 days. Dizziness nausea pain behind left eye continues to get worse. Still seeing doctors and going through testing


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