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

This is VAERS ID 1779020

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Case Details

VAERS ID: 1779020 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-08
Onset:2021-10-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (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? No
Previous Vaccinations:
Other Medications: High fever, chills, muscle aches, tightness of neck, tightness of chest, difficulty breathing, chest pain, chronic sweating
Current Illness: N/A
Preexisting Conditions: Sweating, Muscle Aches
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tightness and pain in the chest, increased heart rate, difficulty breathing. Patient called 911.


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