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

This is VAERS ID 1127043

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Case Details

VAERS ID: 1127043 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-02-16
Onset:2021-02-27
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Pericardial effusion, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: hypertension, type 2 diabetes
Allergies:
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: new onset atrial fibrillation 02/27/2021 (hospitalization #1) pericarditis with pericardial effusion 03/12/2021 (hospitalization #2)


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