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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1769864

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Case Details

VAERS ID: 1769864 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Costochondritis, Dyspnoea, Lymphadenopathy, Oedema peripheral, X-ray
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Other Medications: birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cardic work up, X-rays, blood work maybe more
CDC Split Type:

Write-up: Pt went to urgent care with chest pains and was sent to hospital. pt was hospitalized for a cardiac work up the day after being vaccinated with Pfizer. Presented to ER with chest pain, breathing issues, and a swollen lymph note under left arm. Pt received the Pfizer shot in her left arm. Diagnosis Costochondritis related to the vaccine treated with nsaid and sent home. Pain last a couple of more and has not completely resolve. Pt returned to work 10/7/21


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