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This is VAERS ID 1376872

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1376872
VAERS Form:2
Age:12.0
Sex:Male
Location:Connecticut
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain upper, Blood bilirubin increased, Blood creatine phosphokinase normal, C-reactive protein normal, Chest pain, Chest X-ray normal, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment abnormal, Electrocardiogram ST segment elevation, Fatigue, Fibrin D dimer increased, Full blood count normal, Headache, Myalgia, Myocarditis, Pericarditis, Pyrexia, Sinus tachycardia, Somnolence, Tachycardia, Red blood cell sedimentation rate normal, Ejection fraction, Echovirus test, Epstein-Barr virus test, Adenovirus test, Brain natriuretic peptide increased, Troponin increased, Cytomegalovirus test, Metabolic function test, Oropharyngeal pain, Immunoglobulin therapy, Borrelia test, Parvovirus B19 test, Coxsackie virus test, Herpes virus test, SARS-CoV-2 antibody test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
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: none
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: 6/5 Pro-BNP 193, CRP 1.57, Total bilirubin 1.1, d-dimer 274, troponin initially normal then elevated to peak 3.45, CK normal, ESR normal, CBC normal, BMP normal. 6/5 Troponin 0$g0.33 6/6 Troponin 3.45$g2.08$g1.0 6/5: Chest x-ray normal. 6/5: ECG normal sinus rhythm, diffuse ST changes and J-point elevation particularly in inferolateral leads. Read as early repolarization vs myocarditis 6/6: ECG sinus tachycardia, diffuse ST changes with J point elevation 6/5: Echo obtained read as normal, with EF 60% without pericardial effusion.
CDC 'Split Type':

Write-up: Patient had initial fatigue/ somnolence in AM day after vaccine, in PM developing fever, HA, sore throat, myalgias stomach ache and chest pain. Chest pain every 20-30 minutes, worse when supine, pain with breathing when laying down that resolved when sitting up, presented to ED for workup. Found to be tachycardia to 100s, hemodynamically stable otherwise. Pro-BNP 193, CRP 1.57, Total bilirubin 1.1, d-dimer 274, troponin initially normal then elevated to peak 3.45, CK normal, ESR normal, CBC normal, BMP normal. Chest x-ray normal. ECG normal sinus rhythm, diffuse ST changes and J-point elevation in inferolateral leads. Echo obtained read as normal, with EF 60% without pericardial effusion. Working Diagnosis pericarditis/myocarditis. Cardiology and infectious disease consulted, and started on ibuprofen, tylenol, IVIG, methylprednisolone. Labs for COVID antibodies, lyme, echovirus, HSV 6, EBV, CMV, Parvovirus B19, coxsackie, adenovirus pending. Cardiac MRI planned to be completed.

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