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This is VAERS ID 1376330

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1376330
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood creatine normal, Blood sodium normal, Chest pain, Chills, Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment abnormal, Haematocrit normal, Headache, HIV test, Intensive care, International normalised ratio decreased, Malaise, Myocarditis, Platelet count normal, Prothrombin time prolonged, Pyrexia, White blood cell count decreased, Epstein-Barr virus test, Adenovirus test, Neutrophil percentage decreased, Computerised tomogram thorax normal, Troponin increased, Eosinophil percentage, Lymphocyte percentage, Human herpes virus 6 serology, Cytomegalovirus test, Metabolic function test, Parvovirus B19 test, Enterovirus test, Mycobacterium tuberculosis complex test, Herpes simplex test negative, Magnetic resonance imaging heart, SARS-CoV-2 test negative, SARS-CoV-2 antibody test positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
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: none
Current Illness: None: no cough/cold/URI or other illnesses
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: 6/4: Outside hospital WBC 4.2 HCT: 39.7 Plt: 164 N: 45.2 E:2.9 L: 38.8 CMP: Na 140 Cr: 0.71 AST: 28 ALT 16 Trop: 2980 INR: 1.1 PTT: 29.1 EKG: "reported ST changes" Chest CT: negative for PE 6/4: Troponin 4.90$g$g3.07$g1.41$g1.23$g1.24 ID labs: COVID PCR negative; COVID Ab positive (qual/semi); HSV negative Pending: HHV6/Enterovirus/Parvovirus/CMV/EBV/Adenovirus PCR, EBV panel; HIV; TB Quant Gold Cardiac MRI: 1. Normal left ventricular size and systolic function. 2. Normal right ventricular size and systolic function. 3. No significant valvular disease. 4. No abnormal late gadolinium enhancement. 5. No evidence for active or remote pericarditis. Lack of evidence for active myocarditis. ECHO 6/4: without dysfunction
CDC 'Split Type':

Write-up: 8 hours post vaccination, developed subjective fever, chills, headache, malaise 6/2: Around 32 hours post vaccination, developed acute chest pain, shortness of breath, difficulty breathing when laying flat. Required ibuprofen. 6/3: felt better, required ibuprofen. Presented to ED on 6/4 with continued symptoms (chest pain, shortness of breath), noted to have elevated troponins. Transferred to Hospital on 6/4 to ICU for monitoring. To the floor on 6/5. Clinically doing well just on NSAIDs with slowly decreasing troponins. Dx: probable acute myocarditis per cardiology based on clinical symptoms and troponin leak

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