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This is VAERS ID 1359871

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First Appeared on 6/4/2021

VAERS ID: 1359871
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal distension, Abdominal pain, Activated partial thromboplastin time shortened, Agitation, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood creatine phosphokinase increased, Blood fibrinogen, Blood fibrinogen increased, Blood glucose normal, Blood immunoglobulin A normal, Blood immunoglobulin G normal, Blood immunoglobulin M normal, Blood lactate dehydrogenase increased, Blood lactic acid normal, Blood magnesium increased, Body temperature increased, Catheterisation cardiac normal, Chest discomfort, Chest pain, Chest X-ray normal, Diarrhoea, Discomfort, Echocardiogram normal, Fatigue, Fibrin D dimer increased, Haematocrit normal, Haemoglobin normal, Insomnia, International normalised ratio normal, Irritability, Lymphocyte count normal, Mean cell volume normal, Myocarditis, Nausea, Platelet count normal, Protein total decreased, Prothrombin time shortened, Red blood cell count decreased, Serum ferritin increased, Sleep disorder, White blood cell count increased, Red blood cell sedimentation rate increased, Neutrophil percentage increased, Lymphocyte percentage decreased, Brain natriuretic peptide increased, Laboratory test normal, Mean platelet volume normal, Troponin increased, Troponin I increased, Monocyte percentage, Mycoplasma test positive, Procalcitonin normal, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart, 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)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Acute COVID with positive PCR on april 1 ,2021all 2 sibs twin sister and older sister 21 also positive He had loss of sense of taste and smell x 2 weeks and fatigue ,staying in bed x 5 days and no fever,no headache,no rash,no cough,no chest pain or shortness of breath Not hospitalized Recovered to 100% normal by april 15 2021l
Preexisting Conditions: Diagnosed as Beckwith Wideman as a baby with Hypoglycemia, Genetics not confirmatory No endocrine f/u after 2013 at age 8 Normal growth and development Normal high school in Track
Allergies: amoxicillin
Diagnostic Lab Data: Magnesium 1.8 mg/dL (L) (Ref. Range 2.00 - 2.90) Albumin 3.4 g/dL & (L) (Ref. Range 4.1 - 5.1) Protein- Total 5.9 g/dL (L) (Ref. Range 6.5 - 8.1) Lactate 9.0 mg/dL (Ref. Range 4.5 - 19.8) Procalcitonin 0.10 ng/mL & (H) (Ref. Range 0 - 0.09) ALK Phosphatase 111 U/L (Ref. Range 89 - 365) ALT 41 U/L (H) (Ref. Range 9 - 24) AST 91 U/L (H) (Ref. Range 14 - 35) CPK 1,000 U/L (H) (Ref. Range 80 - 354) LDH 380 U/L (H) (Ref. Range 130 - 250) B-Type Natriuretic Peptide 170 pg/mL (H) (Ref. Range - <100) IgA 112.0 mg/dL (Ref. Range 53.0 - 287.0) IgG 504 mg/dL (L) (Ref. Range 658 - 1,534) IgM 47.0 mg/dL (L) (Ref. Range 48.0 - 186.0) Sedimentation Rate 11 mm/hr (Ref. Range 0 - 20) WBC 14.3 k/uL (H) (Ref. Range 4.5 - 13.0) RBC 5.06 M/uL (Ref. Range 4.50 - 5.30) HEMOGLOBIN 15.0 g/dL (Ref. Range 13.0 - 16.0) HEMATOCRIT 43.6 % (Ref. Range 36 - 51) MCV 86 fL (Ref. Range 78 - 98) PLATELET COUNT 229 k/uL (Ref. Range 150 - 450) Mean Platelet Volume 9.8 fL (Ref. Range 7.4 - 10.4) Diff Type Manual Monocytes 8 % (Ref. Range 4 - 10) Lymphocytes 17 % (L) (Ref. Range 25 - 45) Absolute Lymphocyte Count 2.431 k/uL (Ref. Range 1.10 - 6.00) Neutrophils 73 % (H) (Ref. Range 34 - 64) Bands 2 % (Ref. Range 0 - 11) Ferritin 249 ng/mL (H) (Ref. Range 12.7 - 82.8) Mycoplasma IgG Positive & (A) Mycoplasma IgM Negative & Protime 10.8 Seconds (Ref. Range 8.5 - 12.4) INR 1.0 (Ref. Range 0.8 - 1.2) PTT 23.6 Seconds (Ref. Range 20.0 - 34.4) Fibrinogen 438 mg/dL (H) (Ref. Range 200 - 400) D-Dimer Screen 1.04 mg/L FEU & (H) (Ref. Range - <0.50) BNP 170pg/ml, Ferritin 220ng/mlCOVID PCR NP negative 5/27/2021 15:22 CDT Troponin I 11.82 ng/mL (H) (Ref. Range 0.00 - 0.08 COVID AB positive Glucose 192mg/dl CARDIAC MRI abnormal c/w myocarditis
CDC 'Split Type':

Write-up: On 5/23 two days after vaccine he was irritable, tired, fatigued, not sleeping well. He could not complete his track meet . He had abdominal pain, felt bloated, and he felt this nausea & discomfort. He thought he might be constipated, so he took MiraLAX and then he had diarrhea all day yesterday. on 5/26 he had a temperature of 99.2, he had acute chest pain retrosternal and feeling of compression on the chest, head fullness as if he is going to explode. He had nausea, insomnia. Ibuprofen was given to him by his mother and this helped a lot But he woke up on morning of 5/27 , but the chest pain returned with increased pressure, very nauseous, agitated, unable to be comfortable. No fever,, the pain was a sharp pressure. He had no syncope or chest shortness of breath He was seen at Hospital ER where a chest x-ray was normal. Echocardiogram was done, ,noted to have EKG changes. Troponin was elevated. He had a cardiac catheterization done emergently at hospital through the right radial artery and was noted to have normal coronaries. He also had a chest x-ray done which was negative for pulmonary lesions, and his abdominal pain he says was relieved after the MiraLAX and the diarrhea. His twin sister who received the vaccine 15 minutes after him is completely asymptomatic.

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