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

This is VAERS ID 1481240



Case Details

VAERS ID: 1481240 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arkansas  
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 UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Muscle disorder, Muscular weakness, Myalgia, Pain in extremity, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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: USJNJFOC20210728979

Write-up: CAN''T FOCUS; DECREASED MUSCLE MOVEMENT; ARM PAIN; CAN''T PICK UP A JUG OF MILK; HEADACHE; MUSCLE PAIN; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 03-JUL-2021, the subject experienced can''t focus. On 03-JUL-2021, the subject experienced decreased muscle movement. On 03-JUL-2021, the subject experienced arm pain. On 03-JUL-2021, the subject experienced can''t pick up a jug of milk. On 03-JUL-2021, the subject experienced headache. On 03-JUL-2021, the subject experienced muscle pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, can''t focus, muscle pain, arm pain, decreased muscle movement, and can''t pick up a jug of milk. This report was non-serious.


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