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

This is VAERS ID 1481082



Case Details

VAERS ID: 1481082 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Culture, Streptococcal infection, Streptococcus test
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: Alcoholic (Beer twice a week.); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have had any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Streptococcus identification test; Result Unstructured Data: Positive; Test Date: 20210705; Test Name: Culture nose; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210713761

Write-up: CONFIRMED COVID-19 INFECTION; STREPTOCOCCUS BACTERIAL INFECTION; This spontaneous report received from a patient concerned a 47 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-smoker, and alcoholic, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have had any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 25-JUN-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced streptococcus bacterial infection. Laboratory data included: Streptococcus identification test (NR: not provided) Positive. On 05-JUL-2021, the subject experienced confirmed covid-19 infection. Laboratory data included: Culture nose (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid-19 infection, and the outcome of streptococcus bacterial infection was not reported. This report was non-serious.; Sender''s Comments: V0 Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.


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