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

This is VAERS ID 1118254

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Case Details

VAERS ID: 1118254 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-13
Onset:2021-03-17
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac, Computerised tomogram, Echocardiogram, Electrocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin; terazosin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ekg; ct scan; catheterization; echocardiogram
CDC Split Type:

Write-up: Pericarditis


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