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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1089689



Case Details

VAERS ID: 1089689 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (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: Omeprazole 20 mg once daily
Current Illness: None known
Preexisting Conditions:
Allergies: No known drug allergies
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient began feeling unwell and stated that she was experiencing rapid heart rate after receiving vaccine. Paramedics were called and patient was monitored in a seated position while awaiting emergency services. Patient was transported from the pharmacy via emergency services.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1089689


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