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

This is VAERS ID 1728696

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Case Details

VAERS ID: 1728696 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Pericarditis, Ultrasound scan
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Trip to the ER confirmed pericarditis via EKG, ultrasound, bloodwork
CDC Split Type:

Write-up: acute pericarditis was diagnosed. Toradol injection was given, followed up by high-dose ibuprofen for 10 days.


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