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

This is VAERS ID 1461751



Case Details

VAERS ID: 1461751 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-05
Onset:2021-07-02
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: C-reactive protein normal, Coagulation test normal, Full blood count normal, Metabolic function test, Petechiae, Rash, Red blood cell sedimentation rate normal
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Generalized anxiety
Allergies: None
Diagnostic Lab Data: CBC, CMP, coags, ESR, and CRP were all completely normal. Hemodynamically stable, no fevers.
CDC Split Type:

Write-up: Developed petechial rash to bilateral lower extremities, scattered petechiae to bilateral upper extremities 3 weeks after vaccination. Denies all other medical complaints.


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