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From the 2/12/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 994756

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Case Details

VAERS ID: 994756 (history)  
Form: Version 2.0  
Sex: Female  
Location: Michigan  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dyspnoea, Dyspnoea exertional, Headache, Imaging procedure abnormal, Myalgia, Pericarditis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Jone
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: My mom who is 75 had an adverse reaction on from the COVID vaccine she took on Jan 15, 2021. She went to bed at night and woke up at 4 AM with a severe headache. She took Aleve and went back to bed. When she woke up at 8:30 AM her headache was very severe and was accompanied with very severe chest pain. I immediately took her to the ER. They did a very thorough work up to check on her heart and Aorta. They managed her severe pain with two doses of morphine followed by two days of Dilaudid. The imaging and symptoms left her with a newly discovered diagnosis of Pericarditis. The medical professions were sure this was a result of the COVID vaccine. They continued to treat her for a few days and sent her home with anti inflammatories to help. She continues to have muscle pain, weakness and shortness of breath when she walks. She is scheduled to take her 2nd dose on February 5th but we are very concerned and hesitant as we don''t want to cause any more damage to her heart. Please have somebody contact us and let us know how to proceed. Thanks.

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