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This is VAERS ID 1310285

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1310285
VAERS Form:2
Age:21.0
Sex:Male
Location:Ohio
Vaccinated:2021-05-08
Onset:2021-05-11
Submitted:0000-00-00
Entered:2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Myocarditis, Troponin increased, Echocardiogram abnormal, Magnetic resonance imaging heart

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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: A
Diagnostic Lab Data: ECHO 5/11 Cardiac MRI 5/11
CDC 'Split Type':

Write-up: Chest pain, elevated troponin. Acute myocarditis confirmed by cardiac MRI

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