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This is VAERS ID 1759951

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1759951
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-09-07
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Supraventricular tachycardia, Myocardial necrosis marker

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Cardiac enzymes; Result Unstructured Data: Test Result:Normal
CDC 'Split Type': FIPFIZER INC202101239677

Write-up: Supraventricular tachycardia; This is a spontaneous report received from a contactable Physician downloaded from the WEB. The regulatory authority report number is FI-FIMEA-20214814. A 14-year-old male patient received BNT162B2 (COMIRNATY) via an unspecified route of administration as a single dose on 07Sep2021 for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 13Sep2021, the patient experienced Supraventricular tachycardia. It was reversed with medication in the university hospital. Cardiac enzymes was normal, no myo/pericarditis as assessed by a pediatric cardiologist. The patient recovered from the event on an unspecified date. No follow-up attempts are possible. Information about lot/batch number cannot be obtained. No further information is expected.

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