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

This is VAERS ID 1442303



Case Details

VAERS ID: 1442303 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Muscle spasms, Nodule, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (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: BENAZEPRIL; AMLODIPINE; METFORMIN
Current Illness: Blood pressure; Diabetes
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210660975

Write-up: EXTREMELY LARGE BRUISE 5 INCH LONG ON FOREARM; BUMP NODULE PEA SIZE; CRAMPING IN LEGS; SORE ARM; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included blood pressure, and diabetes.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: 09-JUL-2021) dose was not reported, administered on 24-JUN-2021 for prophylactic vaccination. Concomitant medications included amlodipine for blood pressure, benazepril for blood pressure, and metformin for diabetes. On 25-JUN-2021, the subject experienced extremely large bruise 5 inch long on forearm. On 25-JUN-2021, the subject experienced bump nodule pea size. On 25-JUN-2021, the subject experienced cramping in legs. On 25-JUN-2021, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from extremely large bruise 5 inch long on forearm, bump nodule pea size, sore arm, and cramping in legs. This report was non-serious.


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