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This is VAERS ID 1256179

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1256179
VAERS Form:2
Age:16.0
Sex:Male
Location:Unknown
Vaccinated:2021-04-21
Onset:2021-04-23
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Myocarditis, Nausea

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Myopericarditis 48 hours after 2nd dose of Pfizer vaccine with chest pain, shortness of breath, and nausea.

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