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This is VAERS ID 1361977

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1361977
VAERS Form:2
Age:16.0
Sex:Male
Location:Oregon
Vaccinated:2021-05-26
Onset:2021-05-29
Submitted:0000-00-00
Entered:2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: C-reactive protein increased, Chest pain, Myocarditis, 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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: elevated high sensitivity troponin ~19k CRP 3.2
CDC 'Split Type':

Write-up: myocaritis - chest pain with elevated troponin reequiring hospital admission. symptoms started 3 days after vaccination which was his second dose of the Pfizer vaccine. First dose was on 5/1/21.

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