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

This is VAERS ID 1205963

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Case Details

VAERS ID: 1205963 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Headache, Pain, Pericarditis, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Adderall XR, metformin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Peanuts, sulfa drugs, penicillin, codeine, morphine
Diagnostic Lab Data: 3/22/21 - ER-chest x-ray, blood work, EKG 4/7/21 - appt w/ cardiologist 4/13/21 - appt w/primary care 4/14/21- appt for echocardiogram TBD - CT Scan w/contrast 4/21/21 follow up/ discuss results of echocardiogram with cardiologist TBD - following up with primary care after CTScan is done
CDC Split Type:

Write-up: Day 1-3 severe headache, fever, fatigue, body aches I was in the bed for 2.5 days. Day 5 - severe chest pain landed me in the ER at Hospital - pericarditis caused by the vaccine. Day 21- finally got into see a cardiologist, started colchicine to try to reduce the inflammation around my heart and prevent it from coming back. An echocardiogram is going to be performed on 4/14/21. Also, right upper quadrant pain when taking a deep breath, a ct scan is being scheduled. Ive not been able to sleep laying down since day 5 following the vaccine. Chest pain, shortness of breath and right upper quadrant pain are all a result of the vaccine.


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