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

This is VAERS ID 1430455



Case Details

VAERS ID: 1430455 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-26
Onset:2021-06-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Afrin, Doxycycline
Current Illness: None
Preexisting Conditions: Asthma
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: At approximately 20 mins after vaccination, patient reporting complaints of dizziness without N/V. Vitals HR 76, RR 16, BP 122/82, O2 96%. Patient reporting she has only had coffee this AM and was given peanut butter crackers. No complaint of vision changes or SOB. Patient left site at 10:30 AM.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430455


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