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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1316800



Case Details

VAERS ID: 1316800 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-27
Onset:2021-05-04
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Atrioventricular block, Cardiac arrest, Cardiac pacemaker insertion
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not sure
Current Illness: None
Preexisting Conditions: Kidney disease and hypertension
Allergies: Sulfa drugs
Diagnostic Lab Data: May 4th 2021
CDC Split Type:

Write-up: Heart block - cardiac arrest - permanent pacemaker


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1316800


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