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

This is VAERS ID 1041183

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Case Details

VAERS ID: 1041183 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-02-12
Onset:2021-02-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Electrocardiogram, Headache, Lethargy, Myocardial infarction, Pain in extremity, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Stated above
CDC Split Type:

Write-up: I did experience some headache and lethargy on Sat. so laid low. I did go for a walk about 3:30 walking up hill at times as is usual. I did have an appetite and prepared dinner. I did not go to work (child play therapist). Sunday I felt more myself and did notice the soreness in my arm was surely not as bothersome as with the first shot. Had a very active day, no walk but yoga class. Prepared a nice dinner for VD and settled in to view television later in the evening. Strangely, the memory of the exact nature of how this started eludes me, but I do recall experiencing discomfort in the very upper extremities of my chest. Sharing this with my husband he wondered if it may have had something to do with sleeping on my right side cramping the rib area due to not sleeping on my left side because of the shot. I also pondered if it might be related to my gym workout on Thursday ? I recall feeling tired and headed to bed. I recall awakening to use the bathroom and feeling a slight brief bout of dizziness. When I did awaken the next morning the chest discomfort was still present to I called the Health Center and was advised to go to the ER. The EKG was fine. The troponin level was elevated to 0.19 so I was told I had suffered a mild myocardial infarction and I was going to the ICU.


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