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

This is VAERS ID 1484749



Case Details

VAERS ID: 1484749 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-03
Onset:2021-07-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Discomfort, Hypoaesthesia, Injected limb mobility decreased, Injection site muscle weakness, Injection site pain, Injection site reaction
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad), Sexual dysfunction (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: atorvastatin 20mg, levothyroxine 75mcg, fluticasone nasal spray, furosemide 20mg, mupirocin ointment, metronidazole 0.75% gel, famotidine 20mg, nystatin cream
Current Illness:
Preexisting Conditions: hypertension, thyroid disease, rosacea, GERD
Allergies: aluminum hydroxide, aspirin, atenolol ,cephalexin, clindamycin, dust mite, erythromycin, pepper, ibuprofen, mercurochrome, triamterene/hydrochlorothiazide, zoledrnic acid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient arrived at the pharmacy 7-19-21 reporting she began to experience left arm weakness between the shoulder and elbow on 7/3/21 .She was unable to move or use the arm for 3 days, at which time it resolved. She also reports a sharp, bone pain just above the injection site-she experiences the pain only when she touches the area, (began 7/3/21). She continues to experience this pain as of the time of this report. She also reports a feeling of compression/numbness on the on the outside of her lower left leg between the ankle and the knee, this started 7/3/21 it has improved but has not completely resolved. Patient states she has not reported this to her health care provider


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