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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1433703



Case Details

VAERS ID: 1433703 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-06-26
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest X-ray abnormal, Chest pain, Dyspnoea, Fibrin D dimer increased, Hyperhidrosis, Nausea, Pain in jaw
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypoglycaemia (broad), Infective pneumonia (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: abnormal chest xray, elevation of d-dimer,
CDC Split Type:

Write-up: chest pain, back pain, nausea, jaw pain, sweaty, shortness of breath


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1433703


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