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This is VAERS ID 967286

History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 967286
VAERS Form:2
Age:44.0
Sex:Male
Location:California
Vaccinated:2021-01-13
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram ST segment elevation, Fatigue, Myalgia, Myocarditis, Pyrexia, Viral infection, Red blood cell sedimentation rate increased, Troponin increased, Electrocardiogram PR segment depression, Electrocardiogram PR segment elevation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dysplipdemia, pre-diabetes, obesity, OSA, s/p COVID infection 8/2/20
Allergies:
Diagnostic Lab Data: Elevated troponin levels and EKG with diffuse slightly upsloping ST elevations and mild PR depressions in precoridal leads and slight PR elevation in Avr. Elevated ESR/CRP.
CDC 'Split Type':

Write-up: s/p vaccination with 2nd Covid Vaccine dose, developed low grade viral type illness with fevers up to 102 with myalgias, fatigue. Began to recover, teh awoke in the morning of 1/16/20 wtih crushing, substernal chest pain. Presented to the emergency department. Was admitted to he hospital - diagnosed with myopericarditis. Stayed in the hospital one night, and discharged the next day.


Changed on 5/7/2021

VAERS ID: 967286 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:California
Vaccinated:2021-01-13
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram ST segment elevation, Fatigue, Myalgia, Myocarditis, Pyrexia, Viral infection, Red blood cell sedimentation rate increased, Troponin increased, Electrocardiogram PR segment depression, Electrocardiogram PR segment elevation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dysplipdemia, pre-diabetes, obesity, OSA, s/p COVID infection 8/2/20
Allergies:
Diagnostic Lab Data: Elevated troponin levels and EKG with diffuse slightly upsloping ST elevations and mild PR depressions in precoridal leads and slight PR elevation in Avr. Elevated ESR/CRP.
CDC 'Split Type':

Write-up: s/p vaccination with 2nd Covid Vaccine dose, developed low grade viral type illness with fevers up to 102 with myalgias, fatigue. Began to recover, teh awoke in the morning of 1/16/20 wtih crushing, substernal chest pain. Presented to the emergency department. Was admitted to he hospital - diagnosed with myopericarditis. Stayed in the hospital one night, and discharged the next day.


Changed on 5/14/2021

VAERS ID: 967286 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:California
Vaccinated:2021-01-13
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram ST segment elevation, Fatigue, Myalgia, Myocarditis, Pyrexia, Viral infection, Red blood cell sedimentation rate increased, Troponin increased, Electrocardiogram PR segment depression, Electrocardiogram PR segment elevation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dysplipdemia, pre-diabetes, obesity, OSA, s/p COVID infection 8/2/20
Allergies:
Diagnostic Lab Data: Elevated troponin levels and EKG with diffuse slightly upsloping ST elevations and mild PR depressions in precoridal leads and slight PR elevation in Avr. Elevated ESR/CRP.
CDC 'Split Type':

Write-up: s/p vaccination with 2nd Covid Vaccine dose, developed low grade viral type illness with fevers up to 102 with myalgias, fatigue. Began to recover, teh awoke in the morning of 1/16/20 wtih crushing, substernal chest pain. Presented to the emergency department. Was admitted to he hospital - diagnosed with myopericarditis. Stayed in the hospital one night, and discharged the next day.

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