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

This is VAERS ID 1091170



Case Details

VAERS ID: 1091170 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray normal, Chills, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Flushing, Headache, Heart rate increased, Heart rate irregular, Hyperhidrosis, Injection site pain, Insomnia, Lymphadenopathy, Malaise, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rubella Shot 1989 resulted in CFS/FIBROMYALGIA for 25 years
Other Medications: hydroclorithiazide
Current Illness: none
Preexisting Conditions: Chronic Fatigue Syndrome, Fibromyalgia
Allergies: pennicilin, gluten, dairy
Diagnostic Lab Data: Elevated heart rate, no confirmation of cause but all physical/heart issues ruled out.
CDC Split Type:

Write-up: Flushed and sweaty after 20 minutes. Heart started beating fast and irregular. Went by ambulance to ER where given complete smattering of tests, 2 EKG''s Chest xrays, Chest CAT scan, blood work and observation. Heart and BP continued to be elevated during stay. PB 168/85 down to 148/74. Heart rate 110 to 85 ish. Discharged from hospital. Bed at 10:15 feeling ok. During the night fever, chills, swollen glands, nausea, severe body aches, headache. fast heart rate, heavy breathing, general malaise, sleeplessness, painful injection site. Took tylenol at 5:00 AM and slept a few hours. Woke at 10 AM with body aches, but heart rate was down to 76 and BP down to 112/74. Continuing the tylenol and wiped out.


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