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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1136622



Case Details

VAERS ID: 1136622 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ESRD on HD. Recent Covid
Preexisting Conditions: H/O of HTN, DM2 on insulin, CAD, HF mrEF, bradycardia s/p ppm, Gout.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had cardiac arrest secondary to MI less than 24 hours from receiving the vaccine. Now on 3 pressors. Although due to the patient''s health condition, this may not have been attributed to the vaccine.


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