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From the 5/7/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 1084789



Case Details

VAERS ID: 1084789 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-07
Onset:2021-03-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest X-ray normal, Chills, Condition aggravated, Dehydration, Dizziness, Fatigue, Headache, Nausea, Pain, Paraesthesia, Pyrexia, SARS-CoV-2 test negative, Urine analysis normal
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), COVID-19 (broad)

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? No
Previous Vaccinations:
Other Medications: CYMBALTA, LEVOTHYROXINE, HYDRCHLOROTHIAZIDE, MELOXICAM, VITAMIN D, VITAMIN E
Current Illness: NONE
Preexisting Conditions: 2018 CVT, VAD WITH CEREBRAL STROKES, HYPERTENSION
Allergies: GOLD, COBALT, NICKLE
Diagnostic Lab Data: COVID TEST- NEGATIVE CHEST XRAY - CLEAR BLOODWORK - NORMAL URINE TEST- NORMAL
CDC Split Type:

Write-up: FEVER OVER 100, SEVERE HEADACHE, BODY ACHES, CHILLS, RIGORS, SHARP PAINS, CAUSED MY NERVE PAIN FROM THE STROKE TO BE VERY BAD, TINGLING ON MY AFFECTED SIDE, NAUSEA, DIZZINESS, DEHYDRATION, FATIGUE. I WAS GIVEN TYLENOL, IBUPROFEN, ZOFRAN, ATIVAN, AND 2 BAGS OF FLUIDS.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=1084789

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