ACUTE RENAL INFARCTION; ARM SORENESS; LITTLE TIRED; SLIGHT HEADACHE; This spontaneous report received from a patient concerned a 54 year old female. The patient's weight was 170 pounds, and height was 67 inches. The patient's concurrent conditions included seasonal allergies, non-smoker, social alcohol drinker (monthly and special occasions), and menopausal symptoms, and other pre-existing medical conditions included no history of drug abuse or illicit drug usage. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported,1 total administered on 09-APR-2021 between 13:00 to 15:00 to left arm for prophylactic vaccination. Concomitant medications included venlafaxine hydrochloride for menopausal symptoms, and ibuprofen for relief of regular aches and pains.  On 10-APR-2021, the patient experienced arm soreness, was little tired, and had slight headache. The patient recovered within 2 days from these events. On an unknown date in JUN-2021, the patient was on vacation and had stomach pain, and thought it was something minor like constipation. On 03-JUL-2021, the patient experienced pain again, around 18:00 in the evening and became severe. By 20:00 the patient went to the emergency room where she underwent laboratory test including unspecified blood test and EKG (electrocardiogram) to rule out cardiac issues. At the emergency room, patient was given medication for gastritis as the pain had subsided and the patient left the emergency room at 23:00. The pain started again at 3:00 am when she got back home. Patient once again went back to the emergency room at around 14:00 due to constant and severe pain. In the emergency room patient underwent laboratory test including unspecified blood test, computerized tomogram (CT) scan, EKG (electrocardiogram), and urinalysis. The computerized tomogram (CAT) scan revealed less density in right kidney indicating acute renal infarction. The patient was treated fentanyl for pain and unknown intravenous (IV) medications. Emergency room physician and two kidney specialists and vascular surgeons looked at the scan and the patient was told that the edges of the infarction are smooth indicating that this could have happened sometime in the past and not recently.  Laboratory data included: Blood test (NR: not provided) not specified, and EKG (NR: not provided) not specified. Laboratory data (dates unspecified) included: Blood test (NR: not provided) not specified, CAT scan (NR: not provided) Less density in right kidney indicating acute renal infarction, CT scan (NR: not provided) not specified, EKG (NR: not provided) not specified, and Urinalysis (NR: not provided) not specified. Treatment medications (dates unspecified) included: fentanyl. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from arm soreness, little tired, and slight headache on 12-APR-2021, and had not recovered from acute renal infarction. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: 20210710956-COVID-19 VACCINE AD26.COV2.S -Acute Renal Infarction. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.