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This is VAERS ID 1048413

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048413
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-27
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Heart rate increased, Myocarditis, Pain in extremity, Blood test

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: blood tests; Result Unstructured Data: Test Result:heart inflammation
CDC 'Split Type': ILPFIZER INC2021170222

Write-up: myocarditis- inflammation of the heart muscle; accelerated heartbeat; shortness of breath; sharp pains that were radiating down his left arm; This is a spontaneous report from two contactable consumers. A 19-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 27Jan2021 at single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient developed myocarditis on unspecified date and died on 01Feb2021 five days after second dose. Patient had no underlying medical conditions prior to the event. Patient was hospitalized in ICU with myocarditis - inflammation of the heart muscle, five days after receiving his second dose of the coronavirus vaccine. The young patient received treatment at a (PRIVACY) clinical center on Sunday night before being transferred for further treatment to (PRIVACY) Medical Center. From when he had received the second dose, he had experienced an accelerated heartbeat, along with shortness of breath and sharp pains that were radiating down his left arm on unspecified date. Lab data included blood tests on unspecified date that revealed the heart inflammation. The patient died on 01Feb2021. It was unknown if autopsy was performed. According to the clinic, it has still not been confirmed that the inflammation was developed as a side effect of the vaccination. However, a number of COVID-19-related myocarditis cases have been reported, according to the Institute of Health. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Myocarditis

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