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This is VAERS ID 1362007

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1362007
VAERS Form:2
Age:17.0
Sex:Unknown
Location:Oregon
Vaccinated:2021-05-27
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 - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Electrocardiogram, Pericarditis, Myocardial necrosis marker

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG with diffuse STE, cardiac enzymes negative
CDC 'Split Type':

Write-up: pericarditis

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1362007&WAYBACKHISTORY=ON


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