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This is VAERS ID 1368721

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368721
VAERS Form:2
Age:16.0
Sex:Male
Location:California
Vaccinated:2021-05-29
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EV0168 / 2 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Condition aggravated, Cough, Echocardiogram normal, Myocarditis, Electrocardiogram T wave abnormal, Troponin increased, Electrocardiogram PR segment depression

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gummy multivitamin
Current Illness: None reported
Preexisting Conditions: none reported
Allergies: Allergic to pollen
Diagnostic Lab Data: Cardiac troponin level increased with evolving EKG changes (depressed PR segment and t-wave changes) and preserved ventricular function Noted when he came in with coughing and associated chest pain. Received second dose of covid vaccine 72 hrs prior ( 5/30/21). Echo notes normal cardiac function.
CDC 'Split Type':

Write-up: Myocarditis: Patient reports developing intermittent non-radiating substernal chest pain (5/30/21 at 7am) one day following his second Pfizer vaccine. He had also been experiencing cough for the last few weeks starting in early May about a week after his first Pfizer vaccine . He states having an intermittent non-productive cough since receiving his first COVID vaccine in early May. Symptoms are worsened by walking or exertion. No leg swelling. Patient presented to the ER where troponin was elevated to 9000 and EKG was consistent with myocarditis . Patient admitted for NSAID treatment, cardiology evaluation and observation. Troponins quickly down-trended and patient clinically stable. Anticipate discharge home in next 24-48 hours.

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