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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1222886



Case Details

VAERS ID: 1222886 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aneurysm, Computerised tomogram, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ODEFSEY 25 MG
Current Illness:
Preexisting Conditions: HIV
Allergies: N/A
Diagnostic Lab Data: CT Scan 04-15-2021
CDC Split Type:

Write-up: Massive aneurysm - deceased 04-15-2021


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1222886

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