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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1758604

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Case Details

VAERS ID: 1758604 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cerebrovascular accident, Laboratory test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: Statin drugs
Diagnostic Lab Data: Various Tests Ran
CDC Split Type:

Write-up: Woke up and entire left side of body was swollen and dragging. Went to the ER and was admitted and diagnosed with a stroke.


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