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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1236791



Case Details

VAERS ID: 1236791 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest pain, Coronary angioplasty, Coronary artery thrombosis, Electrocardiogram, Impaired work ability, Ultrasound scan abnormal
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/9 - 4/11/2021 - EKG, ultrasound, blood work
CDC Split Type:

Write-up: Client awoke with chest pain and visited local ER for suspect M.I. Transferred to Hospital for angioplasty, related to thrombosis in R) coronary artery. Treated for 3 days and released to home with 3 months of follow-up cardiac rehab. Scheduled to return back to work as an auto mechanic on 4/26/2021.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1236791

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