National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 1225732



Case Details

VAERS ID: 1225732 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-15
Onset:2021-04-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN10162 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine normal, Blood urea normal, Chest pain, Fibrin D dimer increased, Haematocrit normal, Haemoglobin normal, Headache, Left ventricular dysfunction, Lymphocyte percentage decreased, Malaise, Monocyte percentage increased, Myalgia, Myocarditis, Neutrophil percentage increased, Platelet count normal, Pyrexia, SARS-CoV-2 test negative, Troponin I increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, Vitamin B12, and vitamin D
Current Illness: Had transient nausea and emesis following consumption of rare-cooked meat in early February, otherwise was well
Preexisting Conditions: Anxiety, depression, vitamin deficiency
Allergies: None
Diagnostic Lab Data: 4/18/21: WBC 13, Hgb 15, Hct 44, Plt count 298. 73% neutrophils, 17% lymphocytes, 9% monocytes. BUN 14, Creatinine 1. Troponin I 1.58 ng/mL. D-dimer 0.91 microg/mL. SARS-coronavirus 2 PCR from NP sampling negative.
CDC Split Type:

Write-up: On 4/16/21, the day after receipt of the second SARS-CoV-2 vaccine the patient developed new headache, fever, malaise, and myalagias. on 4/17/21 the patient then developed chest pain which worsened over time and lead to diagnosis of myocarditis with decreased left ventricle function of 44-47% and with troponin I of 1.58 ng/mL.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1225732


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