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From the 5/14/2021 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 1086316



Case Details

VAERS ID: 1086316 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Patient stated she previously had a reaction to shingles vaccine received. Also when she got infusions of antibiotics in the hos
Other Medications: NONE REPORTED
Current Illness: NONE REPORTED
Preexisting Conditions: MIGRAINES, ALLERGIES
Allergies: PENICILLIN, VANCOMYCIN, ROCEPHIN
Diagnostic Lab Data: Patient reported to the ER later in the day
CDC Split Type:

Write-up: Patient stated after about 15 minutes after receiving vaccine that her face felt numb, she said it feels like it spread from her arm where the shot was given up into her neck and into her face which was numb and tingly


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1086316

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