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From the 7/16/2021 release of VAERS data:

This is VAERS ID 926290



Case Details

VAERS ID: 926290 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-02
Onset:2021-01-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Blood lactic acid, Dyspnoea, Electrocardiogram, Full blood count, Headache, Metabolic function test, Myalgia, Pulmonary embolism, Pyrexia, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: None
Current Illness: Covid positive within 3 weeks of vaccine
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: CBC, CMP, Lactic acid, CT angiogram of thorax with IV contrast to R/O PE, EKG
CDC Split Type:

Write-up: Presented to ED 1/3/2021 Tachycardia, fever, headache and myalgia. Complaints of shortness of breath.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=926290


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