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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1235659



Case Details

VAERS ID: 1235659 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-04-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Chills, Dyspnoea, Electrocardiogram, Fatigue, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: seafood
Diagnostic Lab Data: Const: Well-appearing, NAD, alert, conversant Eyes: PERRL, EOMI HENT: NCAT, MMM Neck: Trachea midline, supple CV: RRR, Warm, well-perfused extremities, cap refill <2 seconds, no r/m/ Const: Well-appearing, NAD, alert, conversant Eyes: PERRL, EOMI HENT: NCAT, MMM Neck: Trachea midline, supple CV: RRR, Warm, well-perfused extremities, cap refill <2 seconds, no r/m/g RESP: Symmetric chest rise, Unlabored respiratory effort, CTAB MSK: No gross deformities appreciated. Atraumatic extremities Skin: Warm, dry. No rashes. Neuro: A/Ox3, CN II-XII grossly intact. Symmetric motor function in all extremities. Ambulatory with normal gait Psych: Appropriate mood and affect. LABS: NA RADIOLOGY: NA EKG (my interpretation): - NSR - HR 61 - PR 118; No prolongation. No shortening. - QRS 80; No widening. - QTc 413; No prolongation. - ST: No STE or depression - T: No TWI. No hyperacute or peaked T waves. - No evidence of dysrhythmias, Delta wave, Epsilon wave. No findings of Brugada or LVH. - Nonischemic EKG. Interpreted by myself. PROCEDURES: NA MDM: 21 yo F presents with chest pain. Stable on arrival with reassuring vitals. Patient with normal O2 saturation on RA, not tachycardic. Patient well-appearing on exam with no evidence of respiratory difficulty or other concerning exam findings. EKG nonischemic, with no evidence to suggest STEMI/NSTEMI, pericarditis, dysrhythmia or other severe cardiac or electrolyte abnormality. CXR with no acute findings, such as pleural effusion, PTX, PNA, widened mediastinum. PERC negative. Low suspicion for severe, acute or life-threatening pathology, including as above. Given GI cocktail with improvement. Discussed findings with patient/caregiver. Plan for discharge as above. Patient/caregiver verbalized understanding and agreement with plan. All questions were answered to satisfaction of patient/caregiver. Written and verbal discharge instructions were given to the patient, including strict ER return precautions. Patient was discharged in stable condition. Voice-recognition software was used in the documentation of this note and may contain minor grammatical errors/typos.
CDC Split Type:

Write-up: HISTORY OF PRESENT ILLNESS: 21 yo F p/w midsternal chest burning since 2200 last night. Acute, sharp/burning, constant, mild. No similar prior pain. Reports associated subjective dyspnea. Denies fever, chills, nausea, vomiting, syncope, palpitations, back pain, abdominal pain, weakness/numbness. Patient states she received the J&J COVID vaccine 3 days ago, and had chills, fatigue and body aches that resolved the following day. She has since been asymptomatic.


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