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

This is VAERS ID 1771822

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Case Details

VAERS ID: 1771822 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-23
Onset:2021-10-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: EKG done on 10/2/21 showed PVCs.
CDC Split Type:

Write-up: Premature ventricular contractions very frequently (less than 1 min apart). Began on 10/1/21 at 6pm and continued until 10/2/21 all day. Fewer on 10/3/21 and 10/4/21. Disappeared by 10/5/21.


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