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This is VAERS ID 1341671

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1341671
VAERS Form:2
Age:16.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-05-21
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Echocardiogram abnormal, Troponin normal

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: minocycline, escitalopram, buproprion, dextroamphetamine-amphetamine, multivitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ekg with PR depression, echo with trace pericardial effusion, negative trop
CDC 'Split Type':

Write-up: pericarditis

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