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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1431126



Case Details

VAERS ID: 1431126 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-06
Onset:2021-06-26
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Echocardiogram, Electrocardiogram, Myocarditis, Pericarditis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Cardiomyopathy (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG 2D Echo Troponins
CDC Split Type:

Write-up: Developed myocarditis/pericarditis with EKG changes and high troponins


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1431126


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