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This is VAERS ID 1011883

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 1011883
VAERS Form:2
Age:34.0
Sex:Male
Location:Florida
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray, Condition aggravated, Echocardiogram, Headache, Myocarditis, Pyrexia, Troponin increased, Blood test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cannabidiol
Current Illness: None.
Preexisting Conditions: Previous myopericarditis 5 years prior, pericarditis 7 years prior.
Allergies: None.
Diagnostic Lab Data: Blood work, cardiac echo, chest x ray.
CDC 'Split Type':

Write-up: I had a fever, headache for two days following the vaccine. Two days after I had chest pain and went to the emergency room. I was admitted with elevated troponin and diagnosed with myopericarditis.


Changed on 5/7/2021

VAERS ID: 1011883 Before After
VAERS Form:2
Age:34.0
Sex:Male
Location:Florida
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray, Condition aggravated, Echocardiogram, Headache, Myocarditis, Pyrexia, Troponin increased, Blood test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cannabidiol
Current Illness: None.
Preexisting Conditions: Previous myopericarditis 5 years prior, pericarditis 7 years prior.
Allergies: None. None.
Diagnostic Lab Data: Blood work, cardiac echo, chest x ray.
CDC 'Split Type':

Write-up: I had a fever, headache for two days following the vaccine. Two days after I had chest pain and went to the emergency room. I was admitted with elevated troponin and diagnosed with myopericarditis.


Changed on 5/14/2021

VAERS ID: 1011883 Before After
VAERS Form:2
Age:34.0
Sex:Male
Location:Florida
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray, Condition aggravated, Echocardiogram, Headache, Myocarditis, Pyrexia, Troponin increased, Blood test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cannabidiol
Current Illness: None.
Preexisting Conditions: Previous myopericarditis 5 years prior, pericarditis 7 years prior.
Allergies: None. None.
Diagnostic Lab Data: Blood work, cardiac echo, chest x ray.
CDC 'Split Type':

Write-up: I had a fever, headache for two days following the vaccine. Two days after I had chest pain and went to the emergency room. I was admitted with elevated troponin and diagnosed with myopericarditis.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1011883&WAYBACKHISTORY=ON


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