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This is VAERS ID 1343445

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First Appeared on 5/28/2021

VAERS ID: 1343445
VAERS Form:2
Age:17.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-05-04
Onset:2021-05-24
Submitted:0000-00-00
Entered:2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Chest pain, Echocardiogram, Intensive care, Myocarditis, Pleuritic pain, Ejection fraction decreased, Computerised tomogram thorax, Laboratory test, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Congestion, fever/chills, headache, nausea on day of vaccination that resolved within two days (5/4-5/6)
Preexisting Conditions: Diet controlled Hypertension
Allergies: Peanuts
Diagnostic Lab Data: Complete infectious and MIS-C workup 5/10: Cardiac MRI 5/12 Chest CT 5/7: Echo 5/8: Echo 5/10: Echo 5/13: Echo
CDC 'Split Type':

Write-up: Woke up on 5/7 with pleuritic chest pain, and admitted to the PICU on the same day. Found to have myopericarditis confirmed by MRI, now with residual low-normal EF of 56%. Discharged from hospital on 5/11.

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