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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1641213

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Case Details

VAERS ID: 1641213 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-18
Onset:2021-03-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood test, Carditis, Chest scan, Electrocardiogram, Exercise electrocardiogram, Feeling abnormal, Nausea, Pain, Scan abnormal
SMQs:, Acute pancreatitis (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 1 days
   Extended hospital stay? No
Previous Vaccinations: 1st shot had symptoms, fever, arm felt bad
Other Medications: no
Current Illness: no
Preexisting Conditions: general anxiety, depression
Allergies: Sulphur
Diagnostic Lab Data: EKG Bloodwork Scan of my chest/ MRI or Cat Scan - Fluid with fluid, myocarditis
CDC Split Type: vsafe

Write-up: I had sharp pain left side, I wasn''t feeling good for 2 days. I did a virtual with doctor, she said it could be a heart attack, asked me to go the ER around Mar 4 or 5th 2021. Went to ER, asked to go to heart specialist. Stayed overnight. Did a treadmill test. Nausea and shoulder pain.


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