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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1005747



Case Details

VAERS ID: 1005747 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2020-12-24
Onset:2021-01-15
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FIRST:EJ1685/SE / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Heart rate increased, Influenza A virus test negative, Influenza B virus test, Myocarditis, Respiratory syncytial virus test negative, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1000 mg of PO Tylenol and Pepcid 1 tablet before 2nd dose.
Current Illness: no illnesses
Preexisting Conditions: Ezcema mild
Allergies: no allergies
Diagnostic Lab Data: No test or laboratory results ordered, based soley on assessment and symptoms.
CDC Split Type:

Write-up: Starting last Thursday January 28th ,I started to experience shortness of breath at rest. Friday January 29th I was experiencing constant chest tightness/discomfort. Breath started to catch with speaking, fatigue. On Saturday January 30th at work in teh hospital I moved a heavy patient, became short of breath that the patient heard it and inquired about it, and my heart rate went up into the 120s. After a hot shower on January 31st, my heart rate went into the 110s, shortness of breath experienced. Vital signs have all been normal, no fever, normal blood pressure, normal oxygen saturation. My heart rate only increased on Saturday and Sunday and have been fine since. Negative fro Covid on January 29th and Negative for COVID, flu A and B and RSV on Monday February first. Saw to PCP on Wednesday February 3rd and with my symptoms states it is mild myocarditis from the vaccine, to rest and take an NSAID daily for two weeks.


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