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This is VAERS ID 1463747

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1463747
VAERS Form:2
Age:14.0
Sex:Male
Location:California
Vaccinated:2021-06-30
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW018S / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram normal, Myocarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Autism
Allergies:
Diagnostic Lab Data: EKG - 7/2/21 - NSR
CDC 'Split Type':

Write-up: Chest pain, Myocarditis, seen in ED on 7/2/21 (2 days after vaccine) with diagnosis confirmed. no EKG changes, treated with toradol and ibuprofen 600mg TID x 5 days, symptoms resolved by 7/9/21

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