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

This is VAERS ID 1454232



Case Details

VAERS ID: 1454232 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-07-07
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: none
Current Illness: None noted
Preexisting Conditions: None noted
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 N Gene Swab on 7July2021 Virus Detected
CDC Split Type:

Write-up: Pt Tested positive for COVID-19 after vaccination with Janssen Vaccine and is symptomatic for COVID-19.


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