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This is VAERS ID 1310120

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1310120
VAERS Form:2
Age:16.0
Sex:Male
Location:Ohio
Vaccinated:2021-05-06
Onset:2021-05-10
Submitted:0000-00-00
Entered:2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest pain, Echocardiogram, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Lymphadenopathy, Myocarditis, Troponin T increased, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG 5/10/21 abnormal, diffusely elevated ST segments Troponin T (ng/L) 5/10/21 were 849, 869 Echo (TTE) on 5/10/21 (limited) and 5/11/21 (full) with normal EF and grossly unremarkable Cardiac MRI 5/11/21 showed focal inflammatory changes in the lateral and apical walls consistent with myocarditis. reactive appearing left axillary lymphadenopathy consistent with recent vaccine
CDC 'Split Type':

Write-up: The patient developed severe chest pain on the 4th day after the vaccine, he presented to the local emergency room and had the abnormal tests as described below. His symptoms improved rapidly but due to active myocarditis was given recommendations for limited activity to reduce risk of fatal arrhythmia

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