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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1484667



Case Details

VAERS ID: 1484667 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-09
Onset:2021-07-18
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram ST segment elevation, Myocarditis, Systolic dysfunction, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Troponins: 24.86 (7/18 13:00), 33.07 (7/18 @ 20:31), 21.34 (7/19 @ 04:35) B-NP: 178 (7/19 @ 05:55) ECHO: systolic dysfunction, LF ejection fraction 56% (7/18 @ 14:22) EKG: ST elevation (7/18 @ 10:25)
CDC Split Type:

Write-up: Myocarditis starting 7/18/21. Treated with oral colchicine and IV ketorolac (NSAIDs). Today is day 2 of hospitalization and patient''s troponins are improving.


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