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

This is VAERS ID 1759990

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Case Details

VAERS ID: 1759990 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-27
Onset:2021-10-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Asthma attack, 42, 3/4/2021, covid 19, Pfizer
Other Medications: Levothyroxine 125 mg, vitamin d, calcium, zinc, vitamin c, multivitamin, iron
Current Illness:
Preexisting Conditions: Hashimotos Thyroiditis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden rapid heart palpitations. Subsided after 2 minutes and drinking water. Did not return.


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