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

This is VAERS ID 1377901

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Case Details

VAERS ID: 1377901 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-08
Onset:2021-03-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angina pectoris, Electrocardiogram, Loss of personal independence in daily activities, Pain, Pericarditis, Ultrasound scan abnormal
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Other ischaemic heart disease (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Larin Birth Control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG and ultrasound, they found fluid around my heart.
CDC Split Type:

Write-up: I started having heart pain about two weeks after getting the vaccine, it escalated very quickly. I was soon having severe heart pain every 20 minutes, and I pushed through this for a few days before I became concerned and couldn''t do my day to day actions with constant stabbing heart pain. I had no prior illnesses or health issues. I went in to my local PMC who gave me an EKG and got me a ultrasound on the area, they then said they say some fluid around my heart, I was diagnosed with pericarditis. They said this was very weird for a healthy 18 year old, and usually I would be seriously ill before this happened. A few months have passed, the treatment has not worked and now I''m going through more medication and testing.


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