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

This is VAERS ID 1470430



Case Details

VAERS ID: 1470430 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-05
Onset:2021-07-13
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SARS-CoV-2 N gene Resp Ql NAA+probe~SARS-COV-2 (COVID-19) CLINIC COLLECT KIT OR EXTERNAL KIT performed on 7/13/2021 at 11:29. Test came back positive. Based on case investigation documentation, client is asymptomatic and reports no chronic health conditions.


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