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This is VAERS ID 1274640

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1274640
VAERS Form:2
Age:31.0
Sex:Male
Location:Georgia
Vaccinated:2021-02-24
Onset:2021-02-27
Submitted:0000-00-00
Entered:2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK LA / SYR

Administered by: Military      Purchased by: ??
Symptoms: Blood culture, Catheterisation cardiac abnormal, Electrocardiogram, Myocarditis, Cardiac disorder, Ultrasound scan abnormal, Cardiovascular symptom, Magnetic resonance imaging abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     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.

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