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This is VAERS ID 1289987

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1289987
VAERS Form:2
Age:17.0
Sex:Male
Location:New York
Vaccinated:2021-05-01
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain upper, Chest pain, Dyspnoea, Electrocardiogram abnormal, Fatigue, Headache, Myocarditis, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, Vitamin D and Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin 7 at Hospital and now 19.43 Awaiting cardiac MRI
CDC 'Split Type':

Write-up: The day following the vaccine c/o tactile fever, headache, stomach ache and fatigue (on 5/2). On 5/4 developed chest pain and shortness or breath. Reported to the ER with concerning EKG and troponin levels and therefore transferred where he has been admitted for myocarditis.

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