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This is VAERS ID 1430545

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430545
VAERS Form:2
Age:15.0
Sex:Male
Location:Illinois
Vaccinated:2021-06-25
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 LA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood creatine phosphokinase increased, Chest pain, Myocarditis, Brain natriuretic peptide increased, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: elevated troponin, CK, BNP, chest pain
CDC 'Split Type': n/a

Write-up: myocarditis

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430545&WAYBACKHISTORY=ON


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