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This is VAERS ID 1364955

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1364955
VAERS Form:2
Age:16.0
Sex:Male
Location:Indiana
Vaccinated:2021-05-21
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: School      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Electrocardiogram, Feeling hot, Heart rate increased, Pericarditis, X-ray, Blood test

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Electrocardiogram, blood tests, and x-rays. 5/22/2021
CDC 'Split Type':

Write-up: 14 hours after the vaccination my son began to feel short of breath, warmth in the chest, very fast heartbeat, and chest pain. We immediately went to an emergency room and they detected pericarditis. Followed with a little milder symptoms. He will continue to visit his doctor.

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