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From the 9/17/2021 release of VAERS data:

Found 3,700 cases where Vaccine targets COVID-19 (COVID19) and Symptom is Myocarditis



Case Details

This is page 4 out of 370

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VAERS ID: 1032693 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-02-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: C-reactive protein normal, Drug screen negative, Dry skin, Intensive care, Myocarditis, Pruritus, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Admission HS Trop 1295 on 7 Feb 2021. Peaked 2179 on 7 Feb 2021. Discharge Troponin 1327. ESr 24. CRP 0.3. Urine Drug Screen normal.
CDC Split Type:

Write-up: 26 yo Male developed a laboratory confirmed myocarditis on/about 7 February 2021 after receiving the 2nd dose of Moderna COVID19 Vaccine on 3 Feb 2021. His HS-Tropin peaked at 2179. He was admitted to the ICU for care. Discharged at 72 hour admission. Seen today (16 Feb 2021) for follow-up. Reports no sequela other than the development of dry skin that is pruritic. Multiple pending lab studies ordered/collected to identify other etiologies (Lyme, RPR, Coxsackie, parvo ...). Denies any vaping products.


VAERS ID: 1040340 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-11
Onset:2021-02-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Bacterial test, Blood test, Cardiomegaly, Dehydration, Echocardiogram, Myocarditis, Pulmonary oedema, Viral test, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), 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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bi-polar medications
Current Illness: None
Preexisting Conditions: Obesity
Allergies: unknown
Diagnostic Lab Data: Echocardiogram, testing for bacterial and viral infections, bloodwork
CDC Split Type:

Write-up: Enlarged or inflamed heart, lungs full of fluid, myocarditis, vomiting, dehydration


VAERS ID: 1041804 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-02-15
Onset:2021-02-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arteriogram coronary normal, Blood creatine phosphokinase increased, Blood lactic acid, Brain natriuretic peptide increased, Chest X-ray normal, Chest discomfort, Chills, Computerised tomogram normal, Dyspnoea, Electrocardiogram abnormal, Electrocardiogram normal, Fibrin D dimer increased, International normalised ratio normal, Lipase normal, Lymphadenopathy, Magnetic resonance imaging abnormal, Myocarditis, Nausea, Platelet count decreased, Pyrexia, SARS-CoV-2 test negative, Troponin increased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MVI Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Labs: Troponin 600.3 -$g 609.9 COVID negative Lipase 24 PT 13.5, INR 1.0 140/4.6|100/28|10.4/0.87<114 D-Dimer 0.54 10.1$g14.3/42.9<200, 83% neutrophils Pro BNP 524.6 CK 556 EKG: t-wave inversions in lead II and leads V3-V6 Radiology: 2/17 CXR IMPRESSION: No radiographic evidence of acute cardiopulmonary process. CT PE IMPRESSION: 1. No evidence of pulmonary embolism. 2. Asymmetric left axillary lymphadenopathy for which malignancy is a differential consideration. A regional reactive, inflammatory, or infectious process may be considered after the exclusion of malignancy. Further evaluation with PET/CT would be useful for further imaging evaluation as clinically needed. 3. Incidental, indeterminate liver findings as above. Recommend nonemergent liver MRI for further evaluation. 19FEB2021 TTE Summary Normal LV cavity dimensions, wall thickness, global and segmental systolic function. Normal LVEF estimated at 60-65%. Normal diastolic filling pattern. Normal right ventricular size and function. Normal valvular structure and function. Intracardiac pressures: Unable to estimate pulmonary artery systolic pressure due to lack of tricuspid regurgitation. Normal IVC, normal right atrial pressure. 19FEB2021 Coronary CTA CONCLUSIONS: 1. No coronary artery disease, normal coronary arteries. 2. Bibasilar atelectasis. Otherwise, unremarkable visualized extra cardiac structures. CAD-RADS 0: No plaque or stenosis. RECOMMENDATIONS: Recommend therapeutic lifestyle changes and medical therapy as clinically indicated. 2/19/2021 Cardiac MRI Consistent with myocarditis
CDC Split Type:

Write-up: 30 yo man with no significant past medical history presents to the ED for chest pressure and SOB that started this morning when he woke up. It was a constant 8/10 pressure squeezing at the sides of his sternum with the sensation of a plate pushing down on his sternum, that worsened by taking deep breaths. He had never experienced anything like it before. The pain was neither worsened with exertion nor relieved by rest. It did not change with position, and it did not radiate to his arm/neck. He denies any tenderness to palpation of his chest. Ibuprofen 400 mg did not provide any relief. At time of interview denies SOB and reports decrease in chest tightness to 2/10. CP was significantly relieved with a bolus of normal saline in the ED. Tylenol also effectively reduced his pain. Of note, the patient received the second Moderna COVID vaccine shot 3 days ago. For 2 days after receiving the second shot he experienced fevers, chills, nausea, and intermittent vomiting (10 bouts of non-bloody emesis).


VAERS ID: 1044420 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-09
Onset:2021-01-31
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood creatinine normal, Blood fibrinogen increased, Blood lactic acid, Blood sodium decreased, C-reactive protein increased, Cardiac arrest, Death, Diarrhoea, Fibrin D dimer increased, Multiple organ dysfunction syndrome, Myocarditis, Oropharyngeal pain, Platelet count decreased, Pyrexia, SARS-CoV-2 antibody test positive, Serum ferritin increased, Transaminases, Troponin increased, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-08
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Sodium 131, creatinine 1.2 on admission, transaminases initially normal, lactic acid 2.6, white blood count 11.0, platelets 110, coronavirus nucleocapsid IgG positive, troponin 18, ferritin 1435, fibrinogen 642, D-dimer 5.22, CRP 284
CDC Split Type:

Write-up: Please reference separately submitted MIS-A form. He had sore throat, high fever, diarrhea, deteriorating in to multisystem failure and apparent acute myocarditis, notably with relative initial sparing of the lungs. He suffered cardiac arrest in radiology after developing aphasia and was transferred to Hospital after cannulation for VA ECMO; he died there 2/8/21.


VAERS ID: 1045178 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-02-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Angiogram, Blood creatine phosphokinase, Blood creatine phosphokinase MB, C-reactive protein increased, Chest pain, Computerised tomogram thorax, Dyspnoea, Electrocardiogram, Fibrin D dimer, Full blood count, Inflammatory marker increased, Lipase, Metabolic function test, Myocarditis, Red blood cell sedimentation rate, SARS-CoV-2 test, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: SMOKER 1 PACK/DAY X3 YEARS
Allergies: NONE
Diagnostic Lab Data: EKG; ESR; CRP; LIPASE; TROPONIN; CBC; CMP; CPK; CK-MB; CK; COVID; D-DIMER; CTA (CHEST R/O PE)
CDC Split Type:

Write-up: CHEST PAIN; SOB; ELEVATED INFLAMATORY MARKERS; ELEVATED TROPONIN; MYOCARDITIS


VAERS ID: 1046576 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-02-12
Onset:2021-02-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Myocarditis, Pericarditis, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: 1st dose Moderna Covid 19 - sore arm and rash
Other Medications: ELURYNG, over the counter eye drops
Current Illness: n/a
Preexisting Conditions: Sjogren''s Syndrome - mild, mostly with just dry eyes
Allergies: No
Diagnostic Lab Data: Elevated troponin, CK, ESR. ECG with 1 mm ST elevations throughout. Cardiac Catheterization and Echocardiogram normal.
CDC Split Type:

Write-up: She developed pericarditis/myocarditis and was diagnosed 4 days after receiving second dose of Covid19 Moderna vaccine


VAERS ID: 1046636 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-02-12
Onset:2021-02-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram abnormal, Myocardial necrosis marker increased, Myocarditis, X-ray normal
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After first moderna shot, vomiting, chills, body aches
Other Medications: Lamictal- 100 MG Trileptal- 300 mg AM 600 PM Prozac- 10 MG Birth control contraceptive
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: EKG- abnormal day 1, more normal day 2 2/19 and 2/20 Bloodwork- high cardiac enzymes 2/19 and 2/20, heart in distress and inflamed Cat scan- normal Xray- normal
CDC Split Type:

Write-up: 12 hours after my second Moderna shot, had severe chest pain and shortness of breath. Admitted to emergency room later in the week for myocarditis as a result of the vaccine.


VAERS ID: 1047627 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-02-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen prn
Current Illness: 20 YOM with COVID infection early dec 2020. No symptoms on day of vaccination.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Troponin 11. EKG as above
CDC Split Type:

Write-up: 20 YOM with prior COVID vaccine Dec 2020 presents 4 days after COVID vaccination (First dose) with constant substernal chest pressure, ST early repol vs elevation in ST segment and troponins 11. Onset of chest pain occurred 3 hours after covid vaccine-- 5/10, constant, not positional. Transferred to cardiology inpatient for suspected myocarditis. No prior troponin obtained given prior covid illness.


VAERS ID: 1048204 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-22
Onset:2021-01-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Blood pressure measurement, Chest discomfort, Discomfort, Dizziness, Fatigue, Head discomfort, Hypertension, Impaired work ability, Myocardial necrosis marker, Myocardial necrosis marker increased, Myocarditis, Troponin, Troponin increased
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210122; Test Name: Blood pressure; Result Unstructured Data: Test Result:128/73; Test Date: 20210122; Test Name: Blood pressure; Result Unstructured Data: Test Result:220/116; Test Date: 20210122; Test Name: Cardiac enzymes; Result Unstructured Data: Test Result:Elevated; Test Date: 20210122; Test Name: Troponin; Result Unstructured Data: Test Result:increasing
CDC Split Type: USPFIZER INC2021129982

Write-up: Heart enzymes were elevated; Anaphylactic reaction; Blood pressure was 220/116/ her blood pressure was out of control; dizziness does not allow her to go to work; lingering dizziness; Get a tightening in her chest; Fatigue; Left side of temple toward the crown of head she has pressure on the left side of the body; Left side of temple toward the crown of head she has pressure on the left side of the body; lightheadedness; troponin kept increasing; Inflammation around heart; This is a spontaneous report from two contactable consumers or other non health professional (including patient self, a healthcare worker works with patients with lymphomas, a licensed massage/lymphatic therapist). This 53-years-old female received her 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EL1283, Expiry Date: 30Apr2021) at 0.3 ml single dose intramuscular injection in left arm on 22Jan2021 10:28 (also reported as 10:38) for Covid-19 vaccination. Medical history was none (also reported as no patient history). Concomitant drug was none (reported as no other products). Family Medical History Relevant to AE(s) was none. Historical vaccine included flu shot in Nov2020 for immunisation. History of all previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available) was none. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. No other vaccines given the same day or 4 weeks prior. AE(s) following prior vaccinations was none. Patient never had a reaction to any vaccine or shot before. Patent experienced anaphylactic reaction on 22Jan2021, heart enzymes elevated on 22Jan2021, blood pressure was out of control on 22Jan2021, get a tightening in her chest on an unknown date, lingering dizziness on an unknown date, dizziness did not allow her to go to work on an unknown date, inflammation around heart on 22Jan2021, troponin kept increasing on 22Jan2021, fatigue on an unknown date, lightheadedness on an unknown date, left side of temple toward the crown of head she has pressure on the left side of the body on an unknown date. Seriousness for heart enzymes elevated and anaphylactic reaction was hospitalization from 22Jan2021 to 23Jan2021. The events anaphylactic reaction required a visit to Emergency Room, but not Physician Office. The event clinical course was as follows: patient received her 1st dose of the Pfizer vaccine she had an anaphylactic reaction. She was given 3-4 Epis on site (on 22Jan2021) before being transferred to the ER. In the ambulance, she was administered a 4th EpiPen (on 22Jan2021) before getting to the ER, and then admitted to the cardiac unit on 22Jan2021 for observation. Patient also reported Given 3-4 EpiPens on 22Jan2021 and EpiPen auto-injector was Lack of Effect. No Return Sample Received. When she first started having symptoms, her blood pressure was 128/73. When the symptoms got worse her blood pressure started increasing. Her blood pressure was 220/116, they had to admit her to the cardiac unit because her heart enzymes were elevated and her blood pressure was out of control. Her troponin kept increasing and had inflammation around her heart. Her symptoms of anaphylactic reaction went away that same day, 22Jan2021, at the vaccination from her anaphylactic reaction. Patient was discharged and released from the cardiac unit on that Saturday (23Jan2021 ) around 7:30pm. No one could tell her anything about this since she was still having lingering effects and was getting ready to locate a cardiologist and still has tightness in the chest. She mentioned the dizziness did not allow her to go to work. She experiences it on and off, not consistent but less severe than initially. She still had lingering dizziness and she had to drive for a majority of her day and that was concerning. She said that on the left side she will get a tightening in her chest. She said that no one knows what this means moving forward. Patient was concerned about the severity of the reaction and was still not back to normal. She had never had a reaction to any vaccine or shot before and has been in the military. She needed help, direction since she was still not at the full potential to work. She was still fatigued and has tightness of her chest and those are concerns for her. Patient mentioned a part of the symptoms she also had were lightheadedness and dizziness and that started after the vaccine and it''s not as severe, but she still had it. On left side of her temple toward the crown of her head she had pressure on the left side of the body and that was the same side where she received the injection, on that left side. Outcome of anaphylactic reaction was resolved with sequel on 22Jan2021. Outcome of heart enzymes elevated was resolved on 23Jan2021. Outcome of blood pressure was out of control was resolved with sequel on 23Jan2021. Outcome of lingering dizziness was resolving. Outcome of left side of temple toward the crown of head she had pressure on the left side of the body, lightheadedness was not resolved. Outcome of tightness in the chest and fatigue was not resolved. Outcome of inflammation around heart and troponin kept increasing was resolved with sequel on an unknown date. Outcome of the other event was unknown.


VAERS ID: 1051710 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-02
Onset:2021-02-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Biopsy heart abnormal, Cardiac disorder, Diarrhoea, Myocarditis, Nausea, SARS-CoV-2 antibody test, SARS-CoV-2 test negative, Troponin increased, Urine retinol binding protein increased, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), Noninfectious diarrhoea (narrow), Tubulointerstitial diseases (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: None
Preexisting Conditions: Pancreatic cyst Spondylosis Osteoarthritis Ulcerative colitis-not on medication
Allergies: None
Diagnostic Lab Data: Nasopharyngeal PCR negative for covid 19 on 2/14 and 2/17. 2/18 COVID IgG titer to the spike receptor binding protein was. 1:6400 . Trop
CDC Split Type:

Write-up: On 2/2 received 1 st dose of vaccine. On 2/14 developed nausea, vomiting and diarrhea. Admitted to hospital and found to have a troponin of 72 and coronary angiogram done. Endomyocardial biopsy revealed myocyte damage and mixed inflammatory infiltrate concerning for myocarditis. Patient ultimately has started to recover with treatment of methylpred 1 gram x 3 days.


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