National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1710065

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 9/24/2021

VAERS ID: 1710065
VAERS Form:2
Age:17.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-01
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Chest discomfort, Chest pain, Electrocardiogram abnormal, Pericarditis

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid Solutab
Current Illness: NA
Preexisting Conditions: Epidermoloysis Bullosa Tourettes Syndrome
Allergies: NA
Diagnostic Lab Data: Echo and x-ray scheduled.
CDC 'Split Type':

Write-up: Chest tightness/pain. Abnormal EKG. Pericarditis.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1710065&WAYBACKHISTORY=ON


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