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This is VAERS ID 1340644

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1340644
VAERS Form:2
Age:17.0
Sex:Male
Location:Maryland
Vaccinated:2021-05-12
Onset:2021-05-13
Submitted:0000-00-00
Entered:2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 545 / 2 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, C-reactive protein increased, Chest X-ray normal, Dyspnoea, Electrocardiogram abnormal, Influenza like illness, Intensive care, Myocarditis, Pericarditis, Troponin increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Promethezine
Diagnostic Lab Data: Too many to list in my allotted 5 minutes! Troponin high, c reactive high
CDC 'Split Type':

Write-up: 5/13 began as flu like , 5/14 6:00 pm couldn?t get full breath, went to Patient 1st, chest X-ray nothing , 5/15 4:00 am shoulder pain, couldn?t get full breath, Went to Hospital ER, Ekg progressively abnormal, Troponin and C reactive values increasing, transported to Medical Center ICU pediatric cardiology, physician and cardiologist, she diagnosed myocarditis and pericarditis. 5/18 discharged and home improving.

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