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

This is VAERS ID 1763676

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Case Details

VAERS ID: 1763676 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dizziness, Musculoskeletal chest pain, Pain, Pain of skin, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular 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: TDap body aches and pain, RA flare. July2021
Other Medications: Allegra-D, spironolactone, Amlodipine, sertraline, probiotics
Current Illness: None
Preexisting Conditions: RA, Thoracic aortic aneurysm, HNT, Anxiety and depression.
Allergies: Tree nuts, wheat, some sea food, beans, soy, latex and a host of other things.
Diagnostic Lab Data: Nothing yet, waiting for my Cardiologist to call back or send a message.
CDC Split Type:

Write-up: Chest pain, heart palpitations, lightheaded lasted a few hours. Then soreness in the chest, ribs still having palpitations 24 hours later. Now adding body aches and pains and skin tenderness.


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