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This is VAERS ID 1242167

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1242167
VAERS Form:2
Age:21.0
Sex:Male
Location:New York
Vaccinated:2021-04-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest pain, Echocardiogram, Electrocardiogram, Fatigue, Myalgia, Myocarditis, Troponin, Magnetic resonance imaging heart

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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Troponin I - 9, Echocardiogram was normal, EKG showing diffuse ST elevations, cardiac MRI showing late gadolinium enhancement consistent with myocarditis.
CDC 'Split Type':

Write-up: Shortly after second dose, patient experienced myalgias, fatigue, but 3 days later, developed chest pain with troponin elevations and was found on MRI to have myopericarditis. He is otherwise stable, He is being treated with antiinflammatories with good response

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