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This is VAERS ID 1292713

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1292713
VAERS Form:2
Age:14.0
Sex:Male
Location:Georgia
Vaccinated:2021-04-28
Onset:2021-04-30
Submitted:0000-00-00
Entered:2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood fibrinogen increased, C-reactive protein increased, Chest pain, Dyspnoea, Fibrin D dimer increased, Pyrexia, Serum ferritin increased, Brain natriuretic peptide increased, Troponin increased, Echocardiogram abnormal

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: Creatinine, CPK, BNP, Troponin, ALT, AST, Ferritin, Ddimer, Fibrinogen and CRP all elevated. ECHO abnormal.
CDC 'Split Type':

Write-up: Developed fever, SOB and chest pain 3 days after second vaccine dose.

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