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This is VAERS ID 1360831

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1360831
VAERS Form:2
Age:16.0
Sex:Male
Location:California
Vaccinated:2021-05-26
Onset:2021-05-27
Submitted:0000-00-00
Entered:2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocarditis, Red blood cell sedimentation rate normal, Troponin increased

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: High sensitivity troponins of 640 on 5/29/2021 Normal ESR of 9
CDC 'Split Type':

Write-up: Myocarditis

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