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This is VAERS ID 1284476

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1284476
VAERS Form:2
Age:16.0
Sex:Male
Location:Washington
Vaccinated:2021-04-30
Onset:2021-05-01
Submitted:0000-00-00
Entered:2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private      Purchased by: ??
Symptoms: Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase increased, Basophil count normal, Blood albumin normal, Blood bilirubin increased, Blood calcium normal, Blood chloride normal, Blood creatine normal, Blood creatine phosphokinase increased, Blood creatine phosphokinase MB increased, Blood glucose normal, Blood magnesium increased, Blood urea normal, C-reactive protein increased, Carbon dioxide normal, Chest pain, Chills, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Eosinophil count normal, Globulin, Haematocrit increased, Haemoglobin normal, Headache, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count increased, Myocarditis, Neutrophil count normal, Pain, Platelet count normal, Protein total normal, Pyrexia, Red blood cell count normal, Reticulocyte count decreased, Vomiting, White blood cell count normal, Red blood cell sedimentation rate decreased, Hepatitis B surface antigen negative, Hepatitis B core antigen, Monocyte percentage increased, Brain natriuretic peptide normal, Cardiac imaging procedure abnormal, Red cell distribution width normal, Eosinophil percentage, Neutrophil percentage, Basophil percentage, Blood alkaline phosphatase increased, Lymphocyte percentage, Cytomegalovirus test, Hepatitis C virus core antigen, SARS-CoV-2 antibody 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: None
Current Illness: None
Preexisting Conditions: Obesity
Allergies: None
Diagnostic Lab Data: 5/2/2021 18:58 WBC: 7.49 RBC: 5.49 (H) Hgb: 15.5 Hct: 45.1 MCV: 82.1 MCH: 28.2 MCHC: 34.4 RDW: 12.4 Plt: 205 Differential type: Automated Abs neuts: 4.22 Abs immature grans: 0.02 Abs lymphs: 1.99 Abs monos: 1.10 (H) Abs eos: 0.09 Abs basos: 0.07 Neuts: 56.3 Immature grans: 0.3 Lymphs: 26.6 Monos: 14.7 Eos: 1.2 Basos: 0.9 NRBCs: 0.0 Abs NRBCs: 0.00 Sed rate (ESR): 2 BNP: <10 Magnesium: 2.0 Troponin I: 3.357 (H) Na: 138 K: 3.5 (L) Cl: 99 CO2: 27 Anion gap w/o K: 12 BUN: 12 Creatinine: 0.82 Glucose: 93 SGOT/AST: 37 SGPT/ALT: 18 Alk Phos: 230 Bilirubin total: 1.6 (H) Protein: 7.3 Albumin: 4.4 Globulin (calc): 2.9 A:G Ratio: 1.5 Calcium: 9.0 C-reactive protein: 5.7 (H) 5/2/2021 20:47 Hep B Surface Ag: Negative Hep C Ab: 0.07 Hep B Core Total Ab: Negative Hep B Surf Ab: 0.69 Cytomegalovirus IgG: 1.6 (H) Cytomegalovirus IgM: <0.2 Interpretation: Prior infection,probably not active COVID 19 ab igG: Negative Comment: (note) 5/3/2021 03:30 Troponin I: 4.768 (H) C-reactive protein: 4.4 (H) 5/3/2021 11:00 Troponin I: 6.240 (H) CK: 559 (H) CK-MB: 42.6 (H) Index: 7.6 (H) Interpretation: MB(CK2) is associ... C-reactive protein: 3.6 (H) 5/3/2021 11:00 CK: 559 (H) 5/3/2021 18:45 5/3/2021 18:50 Troponin I: 5.361 (H) C-reactive protein: 2.3 (H) EKG 5/2 and 5/3 with ST segment elevation. Echocardiogram 5/3 with normal function and no wall motion abnormalities Cardiac MRI 5/3 with evidence of myocarditis, no ischemia, normal coronary arteris
CDC 'Split Type':

Write-up: 16 year old male who got first Pfizer Covid vaccine 4/30, then by the next morning experienced non-bilious emesis for a few hours, as well as fever, chills, body aches, and HA. The body aches and HA continued through today when he began experiencing chest pain while lying down. Chest pain improved on sitting up, standing, sitting forward. No shortness of breath.

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