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This is VAERS ID 1209215

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1209215
VAERS Form:2
Age:19.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Fibrin D dimer normal, Full blood count normal, Leukocytosis, Myalgia, Pericarditis, Pyrexia, Viral infection, White blood cell count increased, Muscle tightness, Troponin increased, Metabolic function test normal, Respiratory syncytial virus test negative, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no home meds
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: He presented to emergency department on day of admission. In the ED, he was found to have mild leukocytosis 11.2 with otherwise normal CBC and BMP, a troponin elevation to 0.23, EKG with mild ST elevations in V2 through V4 (most likely early repolarization, not meeting criteria for STEMI) negative D-dimer, negative Covid, influenza, RSV and chest x-ray without acute cardiopulmonary abnormality.
CDC 'Split Type':

Write-up: Per patient he received his second Covid vaccine 3 days prior to arrival and immediately following developed myalgias, subjective fevers and " viral symptoms" which she managed with ibuprofen 2 tabs q6h some improvement. On the day prior to arrival he developed increasing shortness of breath particularly with talking and with ambulation. He also describes chest tightness with deep inspiration, the tightness radiates to back, no radiation to left arm or jaw. Chest tightness is non-positional, but does feel worse immediately after he lies down from ambulation and then slowly dissipates. His last subjective fever was yesterday evening. He has never had a reaction to the vaccine before. He has no allergies. No prior medical conditions he is aware of, and takes no medications. He did not experience any of the symptoms following the first vaccine. He has h/o asymptomatic COVID infection in November 2020. Cardiology consulted for concern of pericarditis post COVID-19 vaccine. He does not have significant ST elevation or PR depression. He also does not have evidence of significant pericardial effusion at this point. The high sensitivity troponins are mildly elevated. He does have viral syndrome. Is unclear if Covid vaccination was causally related to his symptoms. We would like to improve his medications for better chest pain control and to prevent recurrent pericarditis in the future.


Changed on 5/7/2021

VAERS ID: 1209215 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Fibrin D dimer normal, Full blood count normal, Leukocytosis, Myalgia, Pericarditis, Pyrexia, Viral infection, White blood cell count increased, Muscle tightness, Troponin increased, Metabolic function test normal, Respiratory syncytial virus test negative, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no home meds
Current Illness:
Preexisting Conditions:
Allergies: NKDA NKDA
Diagnostic Lab Data: He presented to emergency department on day of admission. In the ED, he was found to have mild leukocytosis 11.2 with otherwise normal CBC and BMP, a troponin elevation to 0.23, EKG with mild ST elevations in V2 through V4 (most likely early repolarization, not meeting criteria for STEMI) negative D-dimer, negative Covid, influenza, RSV and chest x-ray without acute cardiopulmonary abnormality.
CDC 'Split Type':

Write-up: Per patient he received his second Covid vaccine 3 days prior to arrival and immediately following developed myalgias, subjective fevers and " viral symptoms" which she managed with ibuprofen 2 tabs q6h some improvement. On the day prior to arrival he developed increasing shortness of breath particularly with talking and with ambulation. He also describes chest tightness with deep inspiration, the tightness radiates to back, no radiation to left arm or jaw. Chest tightness is non-positional, but does feel worse immediately after he lies down from ambulation and then slowly dissipates. His last subjective fever was yesterday evening. He has never had a reaction to the vaccine before. He has no allergies. No prior medical conditions he is aware of, and takes no medications. He did not experience any of the symptoms following the first vaccine. He has h/o asymptomatic COVID infection in November 2020. Cardiology consulted for concern of pericarditis post COVID-19 vaccine. He does not have significant ST elevation or PR depression. He also does not have evidence of significant pericardial effusion at this point. The high sensitivity troponins are mildly elevated. He does have viral syndrome. Is unclear if Covid vaccination was causally related to his symptoms. We would like to improve his medications for better chest pain control and to prevent recurrent pericarditis in the future.


Changed on 5/14/2021

VAERS ID: 1209215 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Fibrin D dimer normal, Full blood count normal, Leukocytosis, Myalgia, Pericarditis, Pyrexia, Viral infection, White blood cell count increased, Muscle tightness, Troponin increased, Metabolic function test normal, Respiratory syncytial virus test negative, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no home meds
Current Illness:
Preexisting Conditions:
Allergies: NKDA NKDA
Diagnostic Lab Data: He presented to emergency department on day of admission. In the ED, he was found to have mild leukocytosis 11.2 with otherwise normal CBC and BMP, a troponin elevation to 0.23, EKG with mild ST elevations in V2 through V4 (most likely early repolarization, not meeting criteria for STEMI) negative D-dimer, negative Covid, influenza, RSV and chest x-ray without acute cardiopulmonary abnormality.
CDC 'Split Type':

Write-up: Per patient he received his second Covid vaccine 3 days prior to arrival and immediately following developed myalgias, subjective fevers and " viral symptoms" which she managed with ibuprofen 2 tabs q6h some improvement. On the day prior to arrival he developed increasing shortness of breath particularly with talking and with ambulation. He also describes chest tightness with deep inspiration, the tightness radiates to back, no radiation to left arm or jaw. Chest tightness is non-positional, but does feel worse immediately after he lies down from ambulation and then slowly dissipates. His last subjective fever was yesterday evening. He has never had a reaction to the vaccine before. He has no allergies. No prior medical conditions he is aware of, and takes no medications. He did not experience any of the symptoms following the first vaccine. He has h/o asymptomatic COVID infection in November 2020. Cardiology consulted for concern of pericarditis post COVID-19 vaccine. He does not have significant ST elevation or PR depression. He also does not have evidence of significant pericardial effusion at this point. The high sensitivity troponins are mildly elevated. He does have viral syndrome. Is unclear if Covid vaccination was causally related to his symptoms. We would like to improve his medications for better chest pain control and to prevent recurrent pericarditis in the future.

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