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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1248105



Case Details

VAERS ID: 1248105 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood culture, C-reactive protein, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram abnormal, Culture urine, Dyspnoea, Echocardiogram, Electrocardiogram, Fibrin D dimer, Full blood count, HIV test, Magnetic resonance imaging heart, Metabolic function test, Myocarditis, Pulmonary embolism, Red blood cell sedimentation rate, Troponin
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Occasional albuterol
Current Illness: N/a
Preexisting Conditions: Idiopathic thrombocytopenic purpura, mild asthma
Allergies: n/a
Diagnostic Lab Data: 4/22 CT PE, EKG, Echo, high sensitivity troponin, CRP, ESR, DDimer, BMP, CBC, blood and urine cultures, HIV test 4/23 Cardiac MRI, EKG, CXR, high sensitivity troponin, CRP, ESR, DDimer, BMP, CBC
CDC Split Type:

Write-up: Patient noticed some SOB and chest tightness the evening after receiving the Pfizer COVID vaccine. A few days later his symptoms worsened to chest pain. He went to the ED and was further transferred to the hospital where he was found to have myocarditis. He is being treated with colchicine and lisinopril.


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