National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/12/2021 release of VAERS data:

This is VAERS ID 1295341

Government Disclaimer on use of this data



Case Details

VAERS ID: 1295341 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Echocardiogram, Electrocardiogram abnormal, Magnetic resonance imaging heart, Myocarditis
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clomid - 75mg/week probiotic multivitamin vitamin d finasteride
Current Illness: none
Preexisting Conditions: sleep apnea
Allergies: none
Diagnostic Lab Data: Heart Catheterization - 5/1 EKG - 5/1, 2, 3 Cardiac MRI - 5/3 Echocardiogram - 5/3
CDC Split Type:

Write-up: Developed chest pains 48 hours after vaccination. Had chest pains daily for several days. 96 hours after vaccination, went to clinic. Tests showed irregular EKG, confirmed myocarditis


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1295341


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166