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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1382039



Case Details

VAERS ID: 1382039 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Myocarditis, Pericarditis, Troponin I increased, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin I (initial): 0.519 ng/mL (6/4/21, 1021) (ref range <.034) Troponin I (peak): 31 ng/mL (6/4/21, 2321) EKG: Diffuse ST elevations w/ PR depression in aVR
CDC Split Type:

Write-up: Acute myopericarditis: chest pain, presenting w/ EKG findings of pericarditis and elevated troponins; improved w/ pain medications and supportive care; no significant complications at time of report (patient remains admitted for care coordination)


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