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

This is VAERS ID 1751746

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Case Details

VAERS ID: 1751746 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Myocarditis, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (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? 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: USJNJFOC20210957261

Write-up: MYOCARDITIS; PERICARDITIS; This spontaneous report received from consumer via social media from another pharmaceutical company concerned multiple patients. The patients weight and height were not reported. No past medical history or concurrent conditions were reported. The patients all received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported 1 total administered for prophylactic vaccination. The batch numbers were not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patients experienced myocarditis and pericarditis. The reporter stated that "the total data of adverse events from Vaccine Adverse Event Reporting System, comprising of all age groups from 14-DEC-2020 to 13-AUG-2021, showed 3033 case reports of myocarditis and pericarditis after vaccination out of which 78 cases were attributed to use of JANSEEN COVID-19 VACCINE". No further details were provided. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the myocarditis and pericarditis was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210944284, 20210957248, 20210957269 and 20210957342.; Sender''s Comments: 20210957261 -COVID-19 VACCINE AD26.COV2.S-Myocarditis , Pericarditis . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


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