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

This is VAERS ID 1777137

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Case Details

VAERS ID: 1777137 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-28
Onset:2021-09-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram normal, Hypoaesthesia, Paraesthesia, Urticaria, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hives
Other Medications: Levothyroxine,
Current Illness: No
Preexisting Conditions: Hypothyroidism Stage III Kidney Failure
Allergies: PCN, Amoxicillin, salsa, codeine, Has reactions to other vaccinations - hives
Diagnostic Lab Data: Went on 9/30/2021 had a CT scan to check for clots. They didn''t find anything. Told her to follow up with PCP.
CDC Split Type:

Write-up: Hives, then numbness started in right middle and ring finger then moved up to arm and shoulder. then stared in toes. Toes don''t have the tingly feeling like the arm. Now noticing right eye vision is not as good A little blurry.


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