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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1449435

Case Details

VAERS ID: 1449435 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Unknown  
Location: Michigan  
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Dizziness, Headache, Heart rate, Heart rate increased, Impaired work ability
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had No known allergies
Diagnostic Lab Data: Test Name: Heart rate; Result Unstructured Data: fast
CDC Split Type: USJNJFOC20210708276

Write-up: LOSS OF WORK; FAST HEART RATE; DIZZINESS; LOSS OF APPETITE; WEAKNESS; BAD HEADACHE; This spontaneous report received from a patient concerned a 59 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A expiry: 05-AUG-2021) dose was not reported, administered on 28-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUN-2021, the subject experienced fast heart rate. On 29-JUN-2021, the subject experienced dizziness. On 29-JUN-2021, the subject experienced loss of appetite. On 29-JUN-2021, the subject experienced weakness. On 29-JUN-2021, the subject experienced bad headache. On an unspecified date, the subject experienced loss of work. Laboratory data (dates unspecified) included: Heart rate (NR: not provided) fast. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fast heart rate, dizziness, weakness, bad headache, and loss of appetite, and the outcome of loss of work was not reported. This report was non-serious.

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