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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1291256

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Case Details

VAERS ID: 1291256 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EV8732 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Cough, Fatigue, Neck pain, Palpitations, Pericarditis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid prior vaccination: Yes)
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: body temperature; Result Unstructured Data: Test Result:low grade fever
CDC Split Type: USPFIZER INC2021442537

Write-up: Similar symptoms to pericarditis, with debilitating pain that was exasperated while lying down; Heart palpitations; left armpit with pain radiating to entire left shoulder through the middle of the neck; low grade fever; severe fatigue; slightly dry cough; This is a spontaneous report from a contactable consumer reporting for himself. A 27-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number EV8732/expiration date: not provided), via an unspecified route of administration, on 07Apr2021 at 13:45 (at the age of 27 years old) as a single dose in the left arm for COVID-19 IMMUNIZATION. Relevant medical history included COVID-19 on an unspecified date. The patient did not have any known allergies to medications, food, or other products. Concomitant medication (other medications taken in two weeks) were none. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 19Apr2021 at 22:00, the patient experienced similar symptoms to pericarditis, with debilitating pain that was exasperated while lying down, Heart palpitations, left armpit with pain radiating to entire left shoulder through the middle of the neck, low grade fever, severe fatigue and slightly dry cough. The events required a physician''s office visit. The patient received treatment for these events. The clinical course of the events was as follows: Heart palpitations originating under left armpit with pain radiating to entire left shoulder through the middle of the neck. Similar symptoms to pericarditis, with debilitating pain that was exasperated while lying down, low grade fever, severe fatigue, and slightly dry cough. Lasted about 30 hours. Discomfort relief, like pericarditis, was only felt when sitting up and propping myself up by my arms leaning forward. Onset was rapid, occurring 13 days after the first dose of the vaccine over a period of 8 hours (palpitations came first, followed by shoulder and neck pain in the morning). Treated with Aspirin at first (low effectiveness) followed by NSAID Advil 7 hours later (high effectiveness, symptom relief was about 50%). High strength Advil recommended by MD. The outcome of the events was recovering. Since the vaccination, the patient had not been tested for COVID-19.


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