National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 1135371

Government Disclaimer on use of this data



Case Details

VAERS ID: 1135371 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-20
Onset:2021-03-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER6203 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein, Catheterisation cardiac normal, Chest pain, Chills, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Left ventricular dysfunction, Magnetic resonance imaging heart, Myalgia, Myocardial oedema, Myocarditis, Neck pain, SARS-CoV-2 test negative, Troponin I
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tadalafil
Current Illness: None
Preexisting Conditions: Mitral valve prolapse
Allergies: None
Diagnostic Lab Data: ECG - 3/23/21 COVID PCR - 3/23/21 Echocardiogram - 3/23/21 Troponin I 3/23/21 and 3/24/21 CRP 3/23/21 Cardiac catheterization 3/23/21 Cardiac MRI -3/25/21
CDC Split Type:

Write-up: Patient developed myalgias and chills the day after vaccination. Three days after vaccination, awoke from sleep wtih burning upper chest and neck pain lasting several hours. Came to the ED. ECG notable for lateral ST elevation. Troponin I elevated. CRP elevated. COVID PCR negative x2. Treated with aspirin and intravenous heparin infusion. Echocardiogram revealed left ventricular systolic dysfunction (EF 48%). Cardiac catheterzation revealed no coronary obstruction or thrombosis. Cardiac MRI revealed late gadolinium enhancement and myocardial edema consistent with acute myocarditis. Max temperature during hospitalization 37.4C.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1135371


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166