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This is VAERS ID 925542

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 925542
VAERS Form:2
Age:30.0
Sex:Male
Location:New York
Vaccinated:2020-12-28
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Pericarditis, Laboratory test normal, Troponin normal, Electrocardiogram PR segment depression

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cefprozil (Hives)
Diagnostic Lab Data: See "Item 18"
CDC 'Split Type':

Write-up: On 1/1/21 (4 days post dose 1), patient developed sudden onset substernal chest pain that resolved and recurred the next day on 1/2/21. Patient was seen in the emergency department. VS were reported WNL, EKG with diffuse ST elevations and subtle PR depressions consistent with pericarditis. ECHO did not show evidence of effusion or tamponade. CXR and basic labs were unremarkable including troponin WNL. Patient sent home with colchicine and NSAIDS with plan for outpatient cardiology follow up. Of note, patient had COVID-19 in April 2020 with documented positive antibodies at that time.


Changed on 5/7/2021

VAERS ID: 925542 Before After
VAERS Form:2
Age:30.0
Sex:Male
Location:New York
Vaccinated:2020-12-28
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Pericarditis, Laboratory test normal, Troponin normal, Electrocardiogram PR segment depression

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cefprozil (Hives) (Hives)
Diagnostic Lab Data: See "Item 18"
CDC 'Split Type':

Write-up: On 1/1/21 (4 days post dose 1), patient developed sudden onset substernal chest pain that resolved and recurred the next day on 1/2/21. Patient was seen in the emergency department. VS were reported WNL, EKG with diffuse ST elevations and subtle PR depressions consistent with pericarditis. ECHO did not show evidence of effusion or tamponade. CXR and basic labs were unremarkable including troponin WNL. Patient sent home with colchicine and NSAIDS with plan for outpatient cardiology follow up. Of note, patient had COVID-19 in April 2020 with documented positive antibodies at that time.


Changed on 5/14/2021

VAERS ID: 925542 Before After
VAERS Form:2
Age:30.0
Sex:Male
Location:New York
Vaccinated:2020-12-28
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Pericarditis, Laboratory test normal, Troponin normal, Electrocardiogram PR segment depression

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cefprozil (Hives) (Hives)
Diagnostic Lab Data: See "Item 18"
CDC 'Split Type':

Write-up: On 1/1/21 (4 days post dose 1), patient developed sudden onset substernal chest pain that resolved and recurred the next day on 1/2/21. Patient was seen in the emergency department. VS were reported WNL, EKG with diffuse ST elevations and subtle PR depressions consistent with pericarditis. ECHO did not show evidence of effusion or tamponade. CXR and basic labs were unremarkable including troponin WNL. Patient sent home with colchicine and NSAIDS with plan for outpatient cardiology follow up. Of note, patient had COVID-19 in April 2020 with documented positive antibodies at that time.

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