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This is VAERS ID 1857386

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/12/2021

VAERS ID: 1857386
VAERS Form:2
Age:16.0
Sex:Male
Location:Colorado
Vaccinated:2021-11-05
Onset:2021-11-06
Submitted:0000-00-00
Entered:2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 32030BD / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Chest pain, Heart rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen
Current Illness: None
Preexisting Conditions: Back pain, pectus carinatum
Allergies: Azithromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Heart rate sustained between 125-132 for two days. Chest tightness. Chest pain day after injection for about four hours. Pain upon inhalation during morning of chest pain.

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