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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1459911

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Case Details

VAERS ID: 1459911 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-06
Onset:2021-05-28
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Echocardiogram, Electrocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin D3 supplement
Current Illness: No
Preexisting Conditions: No
Allergies: Sulpha base
Diagnostic Lab Data: Ekg, blood work, echo cardio, cat scan, heart monitor.
CDC Split Type: vsafe

Write-up: She developed Pericarditis treated by doctor.


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