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

This is VAERS ID 1775307

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Case Details

VAERS ID: 1775307 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-08
Onset:2021-10-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Myalgia, Nausea, Ocular discomfort, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), 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: Tylenol, lidocaine patches, naproxen, vitamin d, fish oil
Current Illness: No illnesses
Preexisting Conditions: Von Willebrand disease
Allergies: No allergies
Diagnostic Lab Data: October 13, 2020 lab tested for COVID-19 via PCR. Confirmed severe levels of disease process.
CDC Split Type:

Write-up: Symptoms began within 12 hours. Woke up from sleep drenched in sweat, body aches in every joint, muscle pain throughout the body when I?d move, 102 temperature. Symptoms did not subside for over 6 hours. Took 1000 mg Tylenol to break the fever and manage pain. Persisting feelings of arthritis in joints through the day. Symptoms started again no less than 10 hours later. Eyes pulsating, nausea, skin pulsing with beats of the heart.


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