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This is VAERS ID 1701113

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First Appeared on 9/17/2021

VAERS ID: 1701113
VAERS Form:2
Age:21.0
Sex:Male
Location:California
Vaccinated:2021-09-11
Onset:2021-09-11
Submitted:0000-00-00
Entered:2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Headache, Metabolic function test, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations: Chest pain following Pfizer dose #1
Other Medications: ibuprofen, albuterol inhaler
Current Illness: - Chest pain, unspecified type - Chronic bilateral low back pain without sciatica - Morbid obesity, concerned OSA Pickwickian syndrome - Lower back pain likely muscle strain vs spondylosis no red flags associated including motor or sensory loss - Costochondritis - SOB (shortness of breath)
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: POCT ECG ordered for same day - Comprehensive metabolic panel; Future - Hemoglobin A1c; Future - Troponin I; Future - CBC (includes DIFF/PLT); Future - Lipid panel; Future - C-reactive protein; Future - Sedimentation rate, automated; Future
CDC 'Split Type':

Write-up: 21 year old male presented for second dose Pfizer developed chest pain within 15 mins of vaccination that escalated to headache in addition to chest pain within the following 5 mins.

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