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This is VAERS ID 1358844

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1358844
VAERS Form:2
Age:15.0
Sex:Male
Location:Georgia
Vaccinated:2021-05-22
Onset:2021-05-26
Submitted:0000-00-00
Entered:2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain, Chest pain, Echocardiogram, Myocarditis, Troponin, Magnetic resonance imaging heart

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flonase, Claritin, Singulair
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Augmentin, Cephalosporins, Grass, Penicillins, pollen, rondec
Diagnostic Lab Data: Troponin, echocardiography and cardiac MRI
CDC 'Split Type':

Write-up: Abdominal pain, chest pain and myopericarditis

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