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This is VAERS ID 1291951

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1291951
VAERS Form:2
Age:24.0
Sex:Male
Location:New York
Vaccinated:2021-04-29
Onset:2021-05-03
Submitted:0000-00-00
Entered:2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Myocarditis, Cardiac imaging procedure abnormal, Troponin T 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:
Current Illness:
Preexisting Conditions:
Allergies: Nuts
Diagnostic Lab Data: cardiac MRI 5/4/21 consistent with myopericarditis, peak 5th generation troponin T 1,360 5/4/21
CDC 'Split Type':

Write-up: vaccine 4/29/21, developed chest pain 5/3/21, cardiac MRI consistent with myopericarditis, peak 5th generation troponin T 1360

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