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

This is VAERS ID 1440882



Case Details

VAERS ID: 1440882 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-28
Onset:2021-06-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Chills, Computerised tomogram, Dizziness, Fall, Gastrooesophageal reflux disease, Headache, Nausea, Oropharyngeal pain, Pain, Pyrexia, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: XRay, CAT Scanz and blood test
CDC Split Type:

Write-up: I woke up very nauseous and woozy. I walked into my sisters room and fell down due to weakness. Expericed the following: Fever - 101.2, Chills, Nauseau, Sore Throat , Soreness, Acid Reflux, Headache. Went to the ER because the soreness of my throat was extreme and did not fit the normal side effects. The outcome was to take Tylenol for the fever and headache. To follow up with doctor.


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