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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1348644

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Case Details

VAERS ID: 1348644 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-26
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Electrocardiogram, Headache, Nausea, Pericarditis
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: autoimmune disease
Allergies: apple, kiwi, penicillin
Diagnostic Lab Data: EkG 5/11 chest x ray 5/11
CDC Split Type:

Write-up: pericarditis, headache, nausea, lasting days. treatment - zofran, colchicine, aspirin, ibuprofen


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