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

This is VAERS ID 1725854

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Case Details

VAERS ID: 1725854 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac discomfort, Dyspnoea, Headache, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GRJNJFOC20210942288

Write-up: HYPERTENSION; BREATHING DIFFICULT; HEADACHE; HEART PRESSURE SENSATION OF; This spontaneous report received from a consumer via a Regulatory Authority (EVHUMAN Vaccines, GR-GREOF-20217999) on 22-SEP-2021 and concerned a 28 year old male. The patient''s weight was 140 kilograms, and height was 180 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number was not reported) dose, 1 total, start therapy date were not reported for covid-19 immunisation. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 10-SEP-2021, the patient experienced heart pressure sensation of. On an unspecified date, the patient experienced hypertension, breathing difficult, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hypertension, and headache, had not recovered from breathing difficult, and the outcome of heart pressure sensation of was not reported. This report was serious (Other Medically Important Condition, and Life Threatening).


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