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From the 5/14/2021 release of VAERS data (an older release, current is 7/16/2021):

This is VAERS ID 1226988



Case Details

VAERS ID: 1226988 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol, Enalapril, Amlodipine Besylate,Levothyroxine,Cephalexin,81grams asprin, Potassium,vitimanD3,proventil, plus a daily vitiman
Current Illness:
Preexisting Conditions: Dilated cardiomyopathy kidney disease COPD and high blood pressure is all I can think of right now
Allergies: Bees she''ll fish & silver drugs plus dye for x-rays.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: April 11th and April 12th I run 103 to 105 fever and had a massive headache felt like my upper body was falling off my shoulders Tuesday night fever started to go down Wednesday Thursday Friday Saturday the 18th still have headache. No fever but still have upset stomach. My cousin died Tuesday April 13 from the same shot that I had on April 10th 2021. I don''t know if that''s what killed him or not the doctor on call at the hospital said no.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1226988


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