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

This is VAERS ID 1240893



Case Details

VAERS ID: 1240893 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-10
Onset:2021-04-19
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Disturbance in attention, Feeling abnormal, Motor dysfunction, Paranasal sinus discomfort, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (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: None
Current Illness: None
Preexisting Conditions: None known
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting 8 days after injection I will go into a brain fog for several hours mid morning. Difficulty concentrating and motor function seems mildly impaired. Visuon is slightly blurred. Also slight pressure across sinuses.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=1240893


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