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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1289438

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Case Details

VAERS ID: 1289438 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-01
Onset:2021-03-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arteriogram coronary abnormal, Back pain, Blood test abnormal, Chest X-ray abnormal, Computerised tomogram coronary artery abnormal, Dyspepsia, Dyspnoea, Echocardiogram, Electrocardiogram abnormal, Fatigue, Immune thrombocytopenia, Magnetic resonance imaging heart, Myocarditis, Neck pain, Pain in extremity, Pericarditis, Platelet count decreased, Pyrexia, Scan with contrast abnormal, Troponin increased, Ultrasound chest, Ultrasound liver, Ultrasound spleen
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: 3/20/21 - 3/24/21 Blood tests every hour for 5 days 3 EKGS Cardiac MRI Angiogram Chest / Heart CT with dye 2 Ultrasounds of heart, lungs, spleen, liver etc Chest X ray 4/23/21 Cardiac MRI
CDC Split Type:

Write-up: Received first dose of Pfizer on 3/1. Felt tired for few days and was fine. Started having neck and back pain and then extreme heart burn, pain down left arm, trouble breathing etc. Admitted into hospital on 3/20/21 with Triponin Level at 1.8 and Blood Platelets level at 20,000. Fever and resting heart rate of 135 BPM. Extreme heart burn and pain down left arm. Triponin level rose to 4.5. Platelet levels did not increase. After multiple blood tests to make sure they were correct Cardiologist and Hematoligist diagnosed as Myopericarditis and ITP blood disorder. Spent 4 days in hospital on heavy Decadron dose for ITP and levels improved. Myopericarditis being treated with Colchicine and Metoprolol. Was discharged from hospital on 3/24 and monitored at home. ITP levels still fluctuating and Myocarditis and Pericarditis are still being treated. No previous history of any heart or blood problems and no family history. 23 year old healthy male with no previous health conditions.


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