National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1623068

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1623068
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood creatine phosphokinase increased, Blood creatine phosphokinase MB increased, C-reactive protein increased, Chest pain, Myocarditis, Troponin increased, Magnetic resonance imaging heart

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood test result- CK, CK-MB, high-sensitivity troponin I, and CRP values were high. Cardiac MRI showed late LGE in posterior wall of the heart.
CDC 'Split Type':

Write-up: Chest pain on the following day (Aug 11), went to see a doctor in a clinic, and was directed to our hosipital. We diagnosed the patient with vaccine-induced myocarditis.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1623068&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166