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

This is VAERS ID 1281795

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Case Details

VAERS ID: 1281795 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-05-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Immunoglobulin therapy, Intensive care, Myocarditis, Troponin I increased, Troponin increased
SMQs:, Myocardial infarction (narrow), 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: None; does have an IUD
Current Illness: Seen at urgent care for abdominal pain about 2 week prior to symptom onset. Workup with CT scan was negative for appendicitis and she got better. She has been also receiving treatment for a rash diagnosed as molluscum contagiosum which has been present for several months prior to vaccinations including acyclovir, topical medications and cryotherapy.
Preexisting Conditions: April 2020 had several episodes of syncope that was evaluated with echocardiography and MRI which were negative
Allergies: None
Diagnostic Lab Data: Echocardiogram Normal right ventricular systolic function. Low-normal left ventricular systolic function. M-mode fractional shortening 27% and biplane left ventricular ejection fraction 56%. Troponin 10.89 ng/mL-max troponin I CRP 5.2 mg/dL
CDC Split Type:

Write-up: acute myocarditis; acute onset chest pain; admitted to the pediatric intensive care unit; about to receive IVIG. Chest pain started 5/1/20 about 2 days after her 2nd Pfizer COVID-19 vaccination


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