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This is VAERS ID 1376873

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1376873
VAERS Form:2
Age:15.0
Sex:Male
Location:Kentucky
Vaccinated:2021-06-03
Onset:2021-06-05
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Echocardiogram normal, Electrocardiogram normal, Myocarditis, Troponin increased

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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Myocarditis as evidence by elevated troponins. Normal EKG and Echo. Treated with NSAIDS and troponins downtrended.

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