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This is VAERS ID 1343066

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1343066
VAERS Form:2
Age:16.0
Sex:Male
Location:Iowa
Vaccinated:2021-04-30
Onset:2021-05-16
Submitted:0000-00-00
Entered:2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood glucose normal, Fibrin D dimer, Haemoglobin normal, Myocarditis, Platelet count normal, Serum ferritin normal, White blood cell count decreased, C-reactive protein decreased, Red blood cell sedimentation rate normal, Brain natriuretic peptide normal, Troponin, Respiratory syncytial virus test negative, SARS-CoV-2 test negative, SARS-CoV-2 antibody test positive

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: doxycycline, retin A
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: initial troponin 9, follow up troponin 1 =1 , cpk 128 , d dimer 0.19, bnp 25, feritin 35, crp x 2 was <0.4, esr =0, glu 106, ALT 108, AST 45, WBC 4.3 hgb 15.6, plts 217 , Covid 19 AB for spike protein was +, Covid 19 PCR neg. initial resp panel PCR neg. workup ongoing with not collected yet hep B and Hep A antibodies, peds resp panel, CMV and EBV antibody panel. HSV igm and igg antibodies, Parvo B19 Igg and igm and others ordered by peds cardiologists
CDC 'Split Type':

Write-up: myopericarditis

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