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From the 1/14/2022 release of VAERS data:

Found 85 cases where Vaccine is COVID19 and Symptom is Multisystem inflammatory syndrome in children

Government Disclaimer on use of this data

Table

   
AgeCountPercent
3-6 Years22.35%
6-9 Years11.18%
9-12 Years44.71%
12-17 Years3338.82%
17-44 Years1517.65%
75+ Years11.18%
Unknown2934.12%
TOTAL85100%



Case Details

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VAERS ID: 1139040 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Cold sweat, Multisystem inflammatory syndrome in children, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Approx 3/8/21 pt dx Covid-19
Preexisting Conditions: unknown
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient''s housemate, called pharmacy 3/26/21 to report pt patient''s sx. 3/25/21 approx. 11:00pm fever up to 100.9 F 3/26/21 approx. 9:00am severe abdominal pain, approx. 12:00pm vomiting x2, approx. 3:45pm pt clammy Pharmacist reviewed literature on FDA website regarding Janssen Vaccine ADE''s. There was a very small percentage of pts that had appendicitis following vaccine. Although pt is 19.5 yrs old, here sx were also consistent with those experiencing MIS-C due to the virus. Pharmacist recommended pt to contact doctor immediately and follow his/her advice as to the need of further medical care. At 4:30pm 3/26/21 Pharmacist contacted pt to see how she was doing. Pt admitted feeling a little better and able to keep down soup. Pt stated that her provider told her sx were normal s/e of vaccine and that she received the vaccine too early, following 3/8/21 dx of COVID. Pt stated provider ordered meds for abdominal pain. Names unknown and not sent to our pharmacy.


VAERS ID: 1282242 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-14
Onset:2021-04-24
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Multisystem inflammatory syndrome in children
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: MIS-C


VAERS ID: 1283374 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Multisystem inflammatory syndrome in children
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Centrum
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Believe it to be Multisystem Inflammatory Syndrome (MIS-C).


VAERS ID: 1289076 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-21
Onset:2021-01-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine increased, Blood lactic acid, Brain natriuretic peptide increased, COVID-19, Cardiomyopathy, Chest X-ray abnormal, Ejection fraction decreased, Immunoglobulin therapy, Intensive care, Lung infiltration, Multisystem inflammatory syndrome in children, Pyrexia, Renal failure, Troponin, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pulmonary hypertension (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: 2D echo LVEF 30-35%, WBC 35K, D-dimer 3.01, troponin 4.21, lactate 5.0, BNP 3179, creatinine 2.64, CXR bilateral infiltrates
CDC Split Type:

Write-up: Patient had a clinical illness consistent with MIS-C after the vaccine but also had confirmed COVID infection. Hospitalized in ICU with high fever, rash, cardiomyopathy (myocarditis), renal failure requiring steroids and IVIG.


VAERS ID: 1324803 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-18
Onset:2021-05-08
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein increased, Chest discomfort, Cough, Full blood count, Multisystem inflammatory syndrome in children, N-terminal prohormone brain natriuretic peptide increased, Neck pain, Pneumonia, Procalcitonin, Pyrexia, Red blood cell sedimentation rate increased, Respiratory failure, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Shock, Troponin I normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: Had cough and chest tightness at time of vaccination.
Preexisting Conditions: History of seizure-like activity.
Allergies: No known allergies
Diagnostic Lab Data: 5/14 SARS-CoV2 PCR negative 5/14 SARS-Cov2 IgG positive 5/14 proBNP 3474 5/14 troponin I 0.02 5/14 CBC: 13.6$g12.3<190 5/14 ESR 57 5/14 CRP 28 mg/dl 5/14 Procalcitonin 1.50
CDC Split Type:

Write-up: Patient received first COVID19 Pfizer vaccine on 4/18. At that time, had about 3 days of cough and chest tightness. Subsequently began having neck pain on 5/8 and received second Pfizer vaccine on 5/9. Then began having fevers (Tmax 103F), cough. Admitted to Hospital on 5/15 with respiratory failure and shock. Unclear etiology of pneumonia vs multisystem inflammatory syndrome in children (MIS-C). Did not initially respond to antibiotics so treatment for MIS-C was initiated. Now slowly improving but still hospitalized.


VAERS ID: 1338829 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood alkaline phosphatase increased, Blood bicarbonate, Blood creatinine normal, Blood fibrinogen increased, Blood potassium normal, Blood sodium decreased, Blood urea normal, Brain natriuretic peptide increased, C-reactive protein increased, Diarrhoea, Haemoglobin normal, Hyponatraemia, Lymphocyte count decreased, Multisystem inflammatory syndrome in children, Musculoskeletal stiffness, Neck pain, Platelet count normal, Pyrexia, Rash papular, SARS-CoV-2 antibody test, SARS-CoV-2 antibody test positive, Serum ferritin normal, Troponin increased, Vomiting, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 5/20 Fibrinogen 785, Ferritin 377, CRP, 321, WBC 16.6, Hgb 14.9, plts 203 BNP 225, troponin 1525 pg/ml Na 132, K 3.9, Bicarb 24, BUN 12, Cr 0.8 AST 32, ALT 31, AlkPhos 285 COVID IgG: detected COVID: not detected
CDC Split Type:

Write-up: 5 days prior to admission on 5/16/21, he received a first Pfizer COVID vaccination. The day after the vaccine, he had neck pain and stiffness. He subsequently developed fever, diarrhea, and vomiting. The day prior to admission, he developed a diffuse popular rash. He was seen in clinic on 5/20 and lab work was obtained, which was consistent with MIS-C findings (elevated troponin, elevated fibrinogen, elevated CRP, hyponatremia, relatively low absolute lymphocyte count).


VAERS ID: 1342270 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Alanine aminotransferase increased, Albumin globulin ratio, Aspartate aminotransferase normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood glucose normal, C-reactive protein increased, Cough, Fibrin D dimer increased, Full blood count, Immunoglobulin therapy, International normalised ratio increased, Metabolic function test, Multisystem inflammatory syndrome in children, N-terminal prohormone brain natriuretic peptide, Nausea, Ocular hyperaemia, Pain, Procalcitonin, Protein total normal, Prothrombin time prolonged, Pyrexia, Respiratory viral panel, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Serum ferritin increased, Troponin T normal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none - However had COVID infection a little over a month prior to vaccination (4/8/21)
Preexisting Conditions: none
Allergies: peanut, apricot flavor
Diagnostic Lab Data: COVID PCR 5/22: Negative COVID antibody 5/22: positive CBC: 5/22: 10.49$g13.3/39.2<311, N 79.9, L 15.2 5/23: 10.56$g12.4/36.3<307 N 79.2 L 15.5 CRP: 5/22: 130.6 5/23: 151.5 D-dimer: 5/22: 608 5/23: 466 Procalcitonin: 5/22: 0.14 Ferritin: 5/22: 150 5/23: 169 RVP: 5/22: negative Troponin T 5/22: <0.010 5/23: <0.010 Pro-BNP 5/22: 25 5/23: 44 CMP: 5/22: 138/4.1/101/26/7-0.67/Gluc 108/Ca 9.5/ AG 11/ Alb 4.3/ TP 7.3/ Total Bili 0.7/ ALP 100/ ALT 37/ AST 26 5/23: 139/4.3/101/25/6-0.68/gluc 124/Cac 9.0/AG 13/Alb 3.7/TP 6.9/Total Bili 0.5/ALP 107/ALT 44/AST 32 PT/INR: 5/22: 14/1.2 5/23: 13.6/1.2 PTT: 5/22: 31.7 5/23: 30.7
CDC Split Type:

Write-up: Fever, eye redness, body pain starting 1 day after vaccine cough, nausea, abdominal pain 3 days after vaccine 1 episode of emesis 5 days after vaccine - Admitted to hospital with suspicion of MIS-C - As per ID and Hem/Onc, Started on IVIG and aspirin (5/23/21) - currently still admitted for management of MIS-C


VAERS ID: 1348070 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Ascites, Aspartate aminotransferase increased, Band neutrophil percentage, Blood bilirubin increased, Blood lactate dehydrogenase increased, C-reactive protein increased, Coronary artery aneurysm, Echocardiogram abnormal, Fatigue, Fibrin D dimer increased, Headache, Hepatic steatosis, Hepatosplenomegaly, Hyperechogenic pancreas, Hyperhidrosis, Hypotension, Immunoglobulin therapy, Laboratory test abnormal, Lipase increased, Multisystem inflammatory syndrome in children, Myalgia, Pain, Pharyngitis streptococcal, Platelet count decreased, Prothrombin time prolonged, Pyrexia, Rash, Rash maculo-papular, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test positive, Serum ferritin increased, Streptococcus test positive, Tachycardia, Ultrasound abdomen abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (narrow), Agranulocytosis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Oropharyngeal infections (narrow), Biliary system related investigations, signs and symptoms (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On admission 5/20/21 patient was febrile to 39 C, hypotensive and tachycardia with systolic blood pressures 90-100 and heart rates in the 120-130s. Labs included thrombocytopenia, bandemia, hyperbilirubinemia and transaminases, elevated lipase, elevated ESR, CRP, D-dimer, LDH, ferritin, and prolonged PT. COVID IgG antibodies were positive as expected given vaccination. The family had no known Covid exposure otherwise. Repeat echocardiogram (5/24/21) showed small fusiform aneurysm in the right coronary artery (Z score 3.0) that was not present on initial echo on admission. Additionally, abdominal ultrasound (5/23/21) showed hepatosplenomegaly and hepatic steatosis, echogenic pancreatic head, and small volume pelvic ascites. On admission 5/20/21: Platelets 106 Bands 60.5% Tbili 1.88 AST 235 ALT 306 Lipase 634 ESR 24 CRP 6.2 D-dimer 13,734 LDH 2,590 Ferritin 1,320 PT 14.3
CDC Split Type:

Write-up: Patient received his first dose of the Pfizer vaccine on 5/7/21. On 5/13/21 he began to feel feverish (unsure Tmax, never took temperature) and was intermittently febrile until hospital admission on 5/20/21. On 5/18/21 he was seen in the ED for fever and tested positive for strep throat and started on amoxicillin. His inflammatory labs were elevated at this time and did not notice improvement on amoxicillin. He returned to the ED on 5/20/21 at which time patient reported headaches on the right side, sharp 7/10 pain which come and go with the fevers as well as fatigue, muscle/body aches, and sweats in addition to persistent fever. He also noticed maculopapular rash on palms and soles and on distal extremities which was not pruritic or painful on day of hospital admission. All infectious workup was negative and patient did not improve on broad spectrum antibiotics. Given his persistent fever, hypotension, and inflammatory labs without other cause, patient was empirically treated for MIS-C and was given IVIG and methylprednisolone as well as being started on prophylactic dose enoxaparin for his elevated D-dimer. Repeat echocardiogram identified a new coronary aneurysm, supporting the diagnosis of MIS-C. Following IVIG and steroids patient remained afebrile and inflammatory markers down trended, however liver enzymes remained elevated at time of discharge. He improved and was discharged to finish steroid course at home with close follow up.


VAERS ID: 1361652 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arteriogram coronary normal, Blood culture negative, Brain natriuretic peptide increased, C-reactive protein increased, Chest X-ray normal, Coagulopathy, Culture urine negative, Echocardiogram normal, Fibrin D dimer increased, Headache, Immunoglobulin therapy, Inflammatory marker increased, Multisystem inflammatory syndrome in children, Prothrombin level increased, Pyrexia, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 antibody test positive, Serum ferritin increased
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seizures when younger-seizure free for several years
Allergies: None
Diagnostic Lab Data: Echocardiogram normal 5/29. Chest CT angiogram normal 5/28. CXR normal 5/28. Covid IgG + 5/28 RPP negative. Cultures of blood and urine negative. DDimer markedly elevated 6529, CRP 164 mg/L, PT elevated.Ferritin 408. PT 19.3. ESR 79.
CDC Split Type:

Write-up: Within 5 days of immunization, developed fever, abdominal pain, headache, elevated inflammatory markers, DDimers, ferritin and BNP and coagulopathy. Admitted to Hospital and evaluated for MIS-C. Observed and treatment recommended for MIS-C with IVIG and steroids.


VAERS ID: 1382338 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Antibody test, Bacterial test, Blood gases, Blood immunoglobulin E, Borrelia test, C-reactive protein increased, CD4 lymphocytes, CD8 lymphocytes, CSF test, Coagulation test, Coxsackie virus test, Ehrlichia test, Electroencephalogram, Encephalitis, Endotracheal intubation, Enterovirus test, Full blood count, Headache, Hyponatraemia, Inappropriate antidiuretic hormone secretion, Intensive care, Laboratory test, Lumbar puncture, Lyme carditis, Magnetic resonance imaging, Multisystem inflammatory syndrome in children, Myocarditis, Polymerase chain reaction, Prothrombin time prolonged, Pyrexia, Respiratory viral panel, Thyroid function test, Toxicologic test, Troponin increased, Varicella virus test, Viral test, Vomiting, West Nile virus test
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Noninfectious encephalitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin 500 mg TID, Auvi-Q 0.3 mg IM PRN anaphylaxis, Flovent 100 mcg Diskus 2 puffs daily
Current Illness: Lyme disease diagnosed 19 days prior to admission (~5/16/21) being treated with amoxicillin
Preexisting Conditions: Tympanostomy tubes, myopia, asthma
Allergies: Nuts
Diagnostic Lab Data: - CSF Studies Pending: VZV PCR, Enterovirus PCR, West Nile Virus antibody, Eastern Equine Encephalitis virus antibody, Lyme Antibody Index, Anti-MOG, Autoimmune encephalitis panel. One tube held/froze - Blood Studies Pending: Enterovirus PCR, Anaplasma/ehrlichia PCR, Rickettsia rickettsii IgG, IgM, Adenovirus PCR, Blood for Lyme Antibody Index, Autoimmune Encephalitis, Anti-MOG, Coxsackie PCR - NP Swab: Viral Respiratory Panel (Myocarditis) negative Serial troponins (highest to date 0.19) Serial CRP (highest to date 4.51) LP EEG Blood gas CBC plus diff x 3 Coags (PT = 15.7) Serial Chem10 Urine tox screen (all negative)IgE 751IgG 553 CD8 and CD4 studies Thyroid panels
CDC Split Type:

Write-up: Patient admitted with a diagnosis of myocarditis and encephalitis, currently still hospitalized at the time of this report. From EHR note: Patient is an otherwise healthy 12yM with recent Lyme disease (erythema migrans) transferred to hospital for hyponatremia, encephalitis, myocarditis. Initially intubated due to aspiration risk, now s/p extubation and stable on RA. Broad workup so far including consultations from neurology, cardiology, immunology, and infectious disease with unclear etiology, s/p MRI and LP with c/f covid-vaccine related myocarditis/encephalitis vs lyme carditis/meningoencephalitis vs less likely MISC vs other. Infectious testing so far negative, patient otherwise has returned to baseline behavior without any current symptoms. He is transferred to general for further workup and evaluation and close monitoring. Diagnosed with Lyme 19 days prior to admission, treated with amoxicillin; p/w headache, fever and vomiting so concern for encephalitis as above vs inflammatory process post-COVID or vaccine. Less likely meningitis given reassuring initial CSF studies. Negative COVID antibody. Resolving hyponatremia, thought to be likely SIADH. Given presentation and maternal history of albinism with immunodeficiency, broad workup sent. Also with c/f possible inflammatory response/MISC-C vs vaccine myocarditis.


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