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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1474228



Case Details

VAERS ID: 1474228 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-15
Onset:2021-07-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT # 202A21A / 1 AR / SC

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin, lotrel, lipitor, ambien
Current Illness: Was in recovery from GBS which had occurred in October 2020.
Preexisting Conditions: HTN, hyperlipidemia
Allergies: eggs (nausea), lactose intolerant, bisoprolol ( AV block), coreg, indocin,
Diagnostic Lab Data: No additional tests.
CDC Split Type:

Write-up: Pt noticed increased weakness in legs after receiving COVID vaccine. Had been walking steadily. Now unsteady with walking, feeling like legs will buckle. Pt referred for home PT.


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