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This is VAERS ID 1427730

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1427730
VAERS Form:2
Age:23.0
Sex:Male
Location:Utah
Vaccinated:2021-06-17
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Catheterisation cardiac normal, Chest pain, Hypokinesia, Myocarditis, Thrombosis, Troponin increased, Echocardiogram abnormal

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: as above.
CDC 'Split Type':

Write-up: Patient presented with chest pain, elevated troponin, peaked at 57.12. Echocardiogram showed normal but with definite lateral wall and apex mildly hypokinetic. LHC revealed normal coronaries. Assume thrombus, myocarditis.

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