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This is VAERS ID 1208348

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1208348
VAERS Form:2
Age:41.0
Sex:Male
Location:California
Vaccinated:2021-03-30
Onset:2021-04-05
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023251 / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocarditis, Pyrexia, Ultrasound scan, Brain natriuretic peptide increased, Troponin increased

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: tested positive for COVID vis PCR on 3/10 was asymptomatic
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Echo trop bnp ecg plan for outpatient cardiac MRI
CDC 'Split Type':

Write-up: mild myocarditis with fevers +constitutional symptoms, trop and BNP elevation (without other cause), ekg abnormalities, EF wl


Changed on 5/7/2021

VAERS ID: 1208348 Before After
VAERS Form:2
Age:41.0
Sex:Male
Location:California
Vaccinated:2021-03-30
Onset:2021-04-05
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023251 / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocarditis, Pyrexia, Ultrasound scan, Brain natriuretic peptide increased, Troponin increased

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: tested positive for COVID vis PCR on 3/10 was asymptomatic
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Echo trop bnp ecg plan for outpatient cardiac MRI
CDC 'Split Type':

Write-up: mild myocarditis with fevers +constitutional symptoms, trop and BNP elevation (without other cause), ekg abnormalities, EF wl


Changed on 5/14/2021

VAERS ID: 1208348 Before After
VAERS Form:2
Age:41.0
Sex:Male
Location:California
Vaccinated:2021-03-30
Onset:2021-04-05
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023251 / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocarditis, Pyrexia, Ultrasound scan, Brain natriuretic peptide increased, Troponin increased

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: tested positive for COVID vis PCR on 3/10 was asymptomatic
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Echo trop bnp ecg plan for outpatient cardiac MRI
CDC 'Split Type':

Write-up: mild myocarditis with fevers +constitutional symptoms, trop and BNP elevation (without other cause), ekg abnormalities, EF wl

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1208348&WAYBACKHISTORY=ON


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