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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1071786



Case Details

VAERS ID: 1071786 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-03
Onset:2021-03-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg Vitamin b Calcium
Current Illness: none
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever (100) and chills all night, headache, and painful injection site.


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1071786


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