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

This is VAERS ID 1546334

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Case Details

VAERS ID: 1546334 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Computerised tomogram normal, Dehydration, Diarrhoea, Fatigue, Hypoaesthesia, Myocardial infarction, Myocardial necrosis marker increased, Myocarditis, Oxygen saturation decreased, Platelet count decreased, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (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? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no made aware to provider
Current Illness: Healthy and fit individual
Preexisting Conditions: no chornic health condition
Allergies: Polyethyleneglycol
Diagnostic Lab Data: Low platelet Heart inflammation Elevated cardiac enzyme
CDC Split Type:

Write-up: Patient received J and J vaccine July 31st around noon. Pt was waited 15 minutes and was fine when left the pharmacy. Patients symptoms started at night. Pt vomitted, had diarrhea and dehydration and numbness on the legs. Monday, pt was given 2 iv bags. Platelet count was low. Tue: pt was at ER for having dehydration, diarrhea and was given 1 iv bag of fluid. On Wed, was briefly was without symptoms, except being tired. Since then, patient continue to have dehydation, and vomitting up until the following Monday (August 9th, 2021). Pt was admitted to the ER. Oxy level dropped to around 60%. Pt was given oxygen. CT scan did not indicate any blood clot. Cardiac enzym was elevated. Scan also showed cardiac inflammation. Doctor determined patient might have experienced minor heart attack or cardiac inflammation. Pt has been transported to Cardiac clinic for further evaluation.


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