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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1768660

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Case Details

VAERS ID: 1768660 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-09-29
Onset:2021-10-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Aphasia, Back pain, Blood test normal, Breast pain, Cardiac flutter, Chest X-ray normal, Chest pain, Costochondritis, Dysarthria, Electrocardiogram normal, Eosinophil count increased, Fibrin D dimer normal, Headache, Human chorionic gonadotropin negative, Hypertension, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Muscle spasms, Nausea, Neck pain, Neutrophil count, Pain, Platelet count normal, Red cell distribution width normal, Troponin increased, White blood cell count normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Lipodystrophy (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Not sure if these are adverse but I do not react well to any vaccine. I had a flu shot in 2010 and was sick with vomiting etc fo
Other Medications: Zinc, quercetin, Chagra Mushroom and Elderberry Syrup for immune health.
Current Illness: COVID-19 in August of 2021.
Preexisting Conditions: None.
Allergies: pennicilin and latex
Diagnostic Lab Data: BP 148/74 155/84 was told this was considered high on the hospital paperwork I have. Blood work drawn Cardiac Testing Troponin result 19 ng/L Endrocrinology Beta hcg qi:Negative Diagnostic Radiology XR Chest PA and LAT 2 View: XR chest pa and lat 2 view (just reporing what I see on paperwork I dont see the word negative but she did say it was clear. Blood test cagulation for D-Dimer VTE: 0.32 mcg/ml FEU (was verbally told everything was fine nothing worrisome present) There are also several genreal chemistry tests and results that I see on all of my paperwork. It is a big list. All showing normal for lymp, nuetro absolute, eos , mchc, rdw, platelet, wbc etc..
CDC Split Type:

Write-up: On October 5th I woke up and worked ( I work from home ) and started to experience chest pain. My chest felt achy and sometimes a sharp pain (on sides of each brest) and sometimes the pain would move to top part left breast above it by chest and then it would be all over. I then felt like my heart was "lurching" and center of chest pain. I continued working and tried to just relax at home. On October 6th I woke up and it felt alot worse and was also going up my neck and back. I was just sitting working. That is when I decided to go to the ER as I was afraid I was having a heart attack or a blood clot may have been forming. When I went to the ER I had blood tests done and an EKG. They came back normal. I also had a chest xray which was clear. But, the Doctor acknowledged the chest pain and said it was chest wall inflammation Costochondritis is the term and she said it was very possible it could be from the vaccine. I was sent home after about 7 1/2 hours of being in the ER since all tests were fine but chest still hurt. Today is 10/7 and I am still having the chest pain, it is not as intense but still there it volleys from feeling dull and a bit more increased pain back down to dull again.


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