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This is VAERS ID 1291851

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1291851
VAERS Form:2
Age:20.0
Sex:Male
Location:New York
Vaccinated:2021-04-28
Onset:2021-04-29
Submitted:0000-00-00
Entered:2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram abnormal, Myocarditis, Pericarditis, Cardiac imaging procedure abnormal, Troponin increased

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ekg c/w pericarditis. troponin (normal 6-22) 693,826,1370(peak) cardiac mri c/w myocarditis
CDC 'Split Type':

Write-up: pt developed chest pain the day after the vaccine that worsened over days- presented to hospital on 5-2-21

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