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

This is VAERS ID 1427384



Case Details

VAERS ID: 1427384 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Heart rate increased, Rash erythematous, Swollen tongue, Tinnitus, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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: LISINOPRIL...10 MG...1 DAILY, FLUOXETINE...20 MG...1...DAILY, PANTOPRAZOLE...4 MG...DAILY, METFORMIN...500 MG TWICE DAILY, TESTOSTERONE... 1 ML...WEEKLY
Current Illness: NONE
Preexisting Conditions: TYPE 2 DIABETIC
Allergies: BEE STING ALLERGIES
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: SWELLING OF TOUNGE, HIGH HEART RATE, BLURRED VISION, RINGING IN EARS, METAL TAISTE IN MOUTH, RED RASH ON HEAD AND CHEST. WAS TREATED AT THE EMERGENCY ROOM AND RELEASED.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1427384


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