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This is VAERS ID 1420182

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1420182
VAERS Form:2
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Fatigue, Lethargy, Pain, Pericarditis, Red blood cell sedimentation rate increased, Electrocardiogram ST-T change, Inflammatory marker increased, Troponin normal

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, but well controlled, on no medications, with no inhaler use in several years.
Allergies: None
Diagnostic Lab Data: Elevated ESR on 6/19, over 2 weeks post-vaccine. Elevated ESR and CRP on 6/22 with normal troponins. Normal ECG and echocardiogram and physical exam with pediatric cardiology on 6/22. Signs and symptoms with elevated inflammatory markers on 6/22 consistent with pericarditis that was resolving at the time of cardiology evaluation on 6/22.
CDC 'Split Type':

Write-up: Pericarditis: severe chest pain worse with being supine, lethargy, fatigue, starting day after vaccine, peaked in pain 3 days post-vaccine, lingering chest pain for at least 2 weeks (still present over 2 weeks later) after vaccine.

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