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This is VAERS ID 1354648

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1354648
VAERS Form:2
Age:17.0
Sex:Male
Location:California
Vaccinated:2021-05-21
Onset:2021-05-23
Submitted:0000-00-00
Entered:2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram ST segment abnormal, Myocarditis, Electrocardiogram P wave abnormal, Cardiac imaging procedure abnormal, Troponin increased, Magnetic resonance imaging heart

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Troponin elevated to max 12.44 on 5/25 Cardiac MRI with findings consistent with myocarditis ST changes and P wave inversions on EKG on 5/25
CDC 'Split Type':

Write-up: myocarditis with elevated troponins, findings on cardiac MRI. No treatment required, self-resolved. Admitted for close monitoring

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