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This is VAERS ID 1225732

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1225732
VAERS Form:2
Age:16.0
Sex:Male
Location:Virginia
Vaccinated:2021-04-15
Onset:2021-04-16
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
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, Malaise, Myalgia, Myocarditis, Platelet count normal, Pyrexia, White blood cell count increased, Left ventricular dysfunction, Neutrophil percentage increased, Monocyte percentage increased, Lymphocyte percentage decreased, Troponin I increased, SARS-CoV-2 test negative

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)? 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.

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