National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 1274640

Government Disclaimer on use of this data



Case Details

VAERS ID: 1274640 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-24
Onset:2021-02-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL926 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Blood culture, Cardiac disorder, Cardiovascular symptom, Catheterisation cardiac abnormal, Electrocardiogram, Magnetic resonance imaging abnormal, Myocarditis, Ultrasound scan abnormal
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Carrots, watermelon, food of the peach family (mild)
Diagnostic Lab Data: Between February 27 and March 2, multiple blood cultures, EKGs, dye catheterization, sonogram, and MRI. All results pointed to inflammation of the heart.
CDC Split Type:

Write-up: Heart attack symptoms resulting from cardiac event, leading to hospitalization for 4 days. Diagnosed with Myocarditis.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1274640


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166