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This is VAERS ID 1365543

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365543
VAERS Form:2
Age:17.0
Sex:Male
Location:Washington
Vaccinated:2021-05-29
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocarditis

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: vyvanse
Current Illness: none
Preexisting Conditions: ADHD
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: myopericariditis

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