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This is VAERS ID 1197826

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1197826
VAERS Form:2
Age:17.0
Sex:Male
Location:California
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RL / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Pericarditis, Troponin increased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro 10 mg
Current Illness: none
Preexisting Conditions: Obesity, anxiety, depression
Allergies: none
Diagnostic Lab Data: See item 18.
CDC 'Split Type':

Write-up: Chest pain developed 3 days following vaccine administration. Presented to ED the morning of 4/11/2021, and was found to have diffuse ST elevation on ECG, and troponin level of 0.52. Received dose of aspirin, and then was transferred to Hospital for treatment and monitoring of pericarditis the afternoon of 4/11. Echo at Hospital with good LV function. Repeat EKG demonstrated ST elevation again, and he was started on ibuprofen 600 mg every 6 hours. Chest pain recurred in the evening of 4/11, but resolved some time after administration of ibuprofen. Troponin level upon arrival to Hospital were 3.92 at 17:11 on 4/11, then rose 8.68 at 23:42 on 4/11 at the time of his worsening chest pain. Chest pain still resolved by morning of 4/12, and troponin level downtrended to 5.87 at 6:22 on 4/12. Diagnosis consistent with myopericarditis.


Changed on 5/7/2021

VAERS ID: 1197826 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:California
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RL / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Pericarditis, Troponin increased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro 10 mg
Current Illness: none
Preexisting Conditions: Obesity, anxiety, depression
Allergies: none none
Diagnostic Lab Data: See item 18.
CDC 'Split Type':

Write-up: Chest pain developed 3 days following vaccine administration. Presented to ED the morning of 4/11/2021, and was found to have diffuse ST elevation on ECG, and troponin level of 0.52. Received dose of aspirin, and then was transferred to Hospital for treatment and monitoring of pericarditis the afternoon of 4/11. Echo at Hospital with good LV function. Repeat EKG demonstrated ST elevation again, and he was started on ibuprofen 600 mg every 6 hours. Chest pain recurred in the evening of 4/11, but resolved some time after administration of ibuprofen. Troponin level upon arrival to Hospital were 3.92 at 17:11 on 4/11, then rose 8.68 at 23:42 on 4/11 at the time of his worsening chest pain. Chest pain still resolved by morning of 4/12, and troponin level downtrended to 5.87 at 6:22 on 4/12. Diagnosis consistent with myopericarditis.


Changed on 5/14/2021

VAERS ID: 1197826 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:California
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RL / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Pericarditis, Troponin increased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro 10 mg
Current Illness: none
Preexisting Conditions: Obesity, anxiety, depression
Allergies: none none
Diagnostic Lab Data: See item 18.
CDC 'Split Type':

Write-up: Chest pain developed 3 days following vaccine administration. Presented to ED the morning of 4/11/2021, and was found to have diffuse ST elevation on ECG, and troponin level of 0.52. Received dose of aspirin, and then was transferred to Hospital for treatment and monitoring of pericarditis the afternoon of 4/11. Echo at Hospital with good LV function. Repeat EKG demonstrated ST elevation again, and he was started on ibuprofen 600 mg every 6 hours. Chest pain recurred in the evening of 4/11, but resolved some time after administration of ibuprofen. Troponin level upon arrival to Hospital were 3.92 at 17:11 on 4/11, then rose 8.68 at 23:42 on 4/11 at the time of his worsening chest pain. Chest pain still resolved by morning of 4/12, and troponin level downtrended to 5.87 at 6:22 on 4/12. Diagnosis consistent with myopericarditis.

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