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This is VAERS ID 1443111

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1443111
VAERS Form:2
Age:13.0
Sex:Male
Location:Minnesota
Vaccinated:2021-06-22
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, Blood fibrinogen increased, C-reactive protein increased, Hepatitis, Hyperbilirubinaemia, Pharyngitis streptococcal, Pyrexia, Rash, Vomiting, Red blood cell sedimentation rate increased, Acute kidney injury, Immunoglobulin therapy, Streptococcus test positive, SARS-CoV-2 test negative, SARS-CoV-2 antibody test negative

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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CRP 221.7, Fibrinogen 575, sed rate 29, AST 65, ALT 77, bilirubin 3.2, Strep throat screen POSITIVE, SARS COVID PCR and AB screen negative.
CDC 'Split Type':

Write-up: Fever, vomiting, rash, hepatitis with direct hyperbilirubinemia, acute kidney injury (resolving) Amoxicillin for strep throat, IVIG for possible Kawasaki disease,

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