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This is VAERS ID 1209960

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1209960
VAERS Form:2
Age:23.0
Sex:Male
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT ON CARD / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Pain, Pain in extremity, Pericarditis, Troponin increased, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: On 4/11 was found to have high triponin levels but when tested with ECG the heart seemed healthy as ever.
CDC 'Split Type':

Write-up: On Saturday night (4/10) I had some chest pains that seemed to not go away in my upper left chest and left arm. I tried to sleep it off until the pain was unbearable at around 7:00 am on Monday (4/11). I then admitted myself to the ER and was given an ECG and multiple EKG?s as well. Upon lab results I had high triponin levels (28) leading the doctors to believe I had a heard attack of some sort, eventually they ruled it as acute pericarditis possibly due to my second dose of the Pfizer vaccine.


Changed on 5/7/2021

VAERS ID: 1209960 Before After
VAERS Form:2
Age:23.0
Sex:Male
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT ON CARD / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Pain, Pain in extremity, Pericarditis, Troponin increased, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data: On 4/11 was found to have high triponin levels but when tested with ECG the heart seemed healthy as ever.
CDC 'Split Type':

Write-up: On Saturday night (4/10) I had some chest pains that seemed to not go away in my upper left chest and left arm. I tried to sleep it off until the pain was unbearable at around 7:00 am on Monday (4/11). I then admitted myself to the ER and was given an ECG and multiple EKG?s as well. Upon lab results I had high triponin levels (28) leading the doctors to believe I had a heard attack of some sort, eventually they ruled it as acute pericarditis possibly due to my second dose of the Pfizer vaccine.


Changed on 5/14/2021

VAERS ID: 1209960 Before After
VAERS Form:2
Age:23.0
Sex:Male
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT ON CARD / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Pain, Pain in extremity, Pericarditis, Troponin increased, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data: On 4/11 was found to have high triponin levels but when tested with ECG the heart seemed healthy as ever.
CDC 'Split Type':

Write-up: On Saturday night (4/10) I had some chest pains that seemed to not go away in my upper left chest and left arm. I tried to sleep it off until the pain was unbearable at around 7:00 am on Monday (4/11). I then admitted myself to the ER and was given an ECG and multiple EKG?s as well. Upon lab results I had high triponin levels (28) leading the doctors to believe I had a heard attack of some sort, eventually they ruled it as acute pericarditis possibly due to my second dose of the Pfizer vaccine.

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