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This is VAERS ID 1430542

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430542
VAERS Form:2
Age:20.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-06-18
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Echocardiogram, Electrocardiogram, Myocarditis, Troponin increased

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Autism
Allergies: Risperidone
Diagnostic Lab Data: 6/21 serial troponins 840, 2470, 2400, 2033, 6/21 cxr - no acute changes, 6/21 EKG, 6/22 EKG, 6/22 Cardiac echocardiogram
CDC 'Split Type':

Write-up: Atypical chest pain, elevated troponin, suspected myocarditis. Inpatient observation for 24 hours; serial troponins, EKG, Echo, pain control (toradol/Naprosyn).

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