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This is VAERS ID 1365552

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365552
VAERS Form:2
Age:17.0
Sex:Male
Location:Colorado
Vaccinated:2021-05-27
Onset:2021-05-29
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Echocardiogram, Echocardiogram normal, Electrocardiogram, Myocarditis, Cardiac imaging procedure abnormal, Troponin increased

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)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: EKG TTE Serial Troponins cardiac MRI
CDC 'Split Type':

Write-up: myo-pericarditis . TTE showed normal LV function, no pericardial effusion, Troponins elevated to as high as 15.8 (still rising) with cMRI confirming myocardial inflammation.

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