|
| VAERS ID: |
1901192 (history) |
| Form: |
Version 2.0 |
| Age: |
8.0 |
| Sex: |
Male |
| Location: |
Wyoming |
| Vaccinated: | 0000-00-00 |
| Onset: | 2021-11-01 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-11-26 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / - |
Administered by: Unknown Purchased by: ? Symptoms: Myocarditis SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: USPFIZER INC202101604541
Write-up: Myocarditis; This is a spontaneous report from a non-contactable consumer. An 8-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on Nov2021, at the age of 8-years-old, (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient received Pfizer vaccine and was in ICU with myocarditis within 2 days (unspecified day of Nov2021). He was "totally healthy and active" prior to vaccination. The outcome of the event was unknown. Treatment was received for the events. The lot number for (BNT162B2), was not provided and will be requested during follow-up. |
|
| VAERS ID: |
1909856 (history) |
| Form: |
Version 2.0 |
| Age: |
9.0 |
| Sex: |
Male |
| Location: |
Unknown |
| Vaccinated: | 2021-11-26 |
| Onset: | 2021-11-29 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-11-30 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 2 |
- / - |
Administered by: Private Purchased by: ? Symptoms: Chest pain,
Electrocardiogram normal,
Fatigue,
Headache,
Myocarditis,
Pyrexia,
Troponin increased SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: 3 days after his 2nd dose of the COVID-19 vaccine, patient had acute onset chest pain in the setting of 3 days of fever, headache and fatigue. Was found to have elevated troponin level indicating myocarditis. Was observed in the hospital overnight, troponin levels continued to down-trend and EKGs were normal, patient discharged home medically stable with close outpatient cardiology follow-up. Total 1 night stay in the hospital |
|
| VAERS ID: |
1914045 (history) |
| Form: |
Version 2.0 |
| Age: |
10.0 |
| Sex: |
Male |
| Location: |
New Mexico |
| Vaccinated: | 2021-11-28 |
| Onset: | 2021-11-29 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-01 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FL0007 / 1 |
LA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Chest pain,
Laboratory test,
Myocarditis SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
Extended hospital stay? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: The day following vaccination the patient had chest pain and went to the hospital. labwork pending, suspected myocarditis. Patients mother is awaiting confirmation. The patient is still in the hospital as of 12/01/2021 |
|
| VAERS ID: |
1916370 (history) |
| Form: |
Version 2.0 |
| Age: |
9.0 |
| Sex: |
Male |
| Location: |
Maryland |
| Vaccinated: | 2021-11-15 |
| Onset: | 2021-11-16 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-02 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
LA / IM |
Administered by: School Purchased by: ? Symptoms: C-reactive protein,
Chest X-ray normal,
Chest pain,
Dyspnoea,
Electrocardiogram,
Fibrin D dimer,
Full blood count,
Myocarditis,
Platelet count,
Troponin SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: Ventolin HFA inhaler Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: CBC, platelets 57, repeat 201, Troponin, D-Dimer, CRP, EKG, CXR WNL CDC Split Type:
Write-up: Developed midsternal chest pain and shortness of breath 11/16/21. Seen at Urgent Care x 2, given Ventolin inhaler. Seen at on 11/23/21 for continued chest pain and intermittent SOB, to r/o myocarditis |
|
| VAERS ID: |
1935242 (history) |
| Form: |
Version 2.0 |
| Age: |
11.0 |
| Sex: |
Male |
| Location: |
California |
| Vaccinated: | 2021-11-08 |
| Onset: | 2021-11-24 |
| Days after vaccination: | 16 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Angiogram,
Bundle branch block right,
C-reactive protein increased,
Chest pain,
Echocardiogram normal,
Electrocardiogram,
Electrocardiogram ST segment abnormal,
Electrocardiogram abnormal,
Pericarditis,
Red blood cell sedimentation rate increased,
Tachycardia,
Troponin normal SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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: Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: Elevated ESR and CRP. Normal troponin. 11/30 EKG- Sinus tachycardia (HR 165) Nonspecific ST abnormality Borderline prolonged QT Borderline ECG 11/30 repeat EKG - Sinus rhythm Incomplete right bundle branch block versus RsR'' in V1 11/30 normal ECHO and CT angiogram CDC Split Type:
Write-up: Patient developed chest pain and tachycardia. Diagnosed with pericarditis. Symptoms started 11/24, hospitalized 11/30. Discharged 12/1 and improving 12/2 with scheduled NSAIDs. |
|
| VAERS ID: |
1936238 (history) |
| Form: |
Version 2.0 |
| Age: |
10.0 |
| Sex: |
Male |
| Location: |
Massachusetts |
| Vaccinated: | 2021-12-05 |
| Onset: | 2021-12-08 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 2 |
- / - |
Administered by: Unknown Purchased by: ? Symptoms: Brain natriuretic peptide increased,
Echocardiogram normal,
Electrocardiogram ST segment elevation,
Intensive care,
Myocarditis,
Pericarditis,
Troponin increased SMQs:, Cardiac failure (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
Extended hospital stay? No Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: troponin elevated BNP elevated diffuse ST elevations on EKG normal TTE CDC Split Type:
Write-up: myocarditis, pericarditis, admitted to PICU for monitoring, anti-inflammatory treatment |
|
| VAERS ID: |
1943384 (history) |
| Form: |
Version 2.0 |
| Age: |
11.0 |
| Sex: |
Male |
| Location: |
Pennsylvania |
| Vaccinated: | 2021-12-06 |
| Onset: | 2021-12-07 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-13 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Unknown Purchased by: ? Symptoms: Electrocardiogram abnormal,
Extrasystoles,
Myocarditis,
Troponin SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Troponin 12/9 = 5.5 CDC Split Type:
Write-up: myocarditis with troponin leak and EKG abnormalities and ectopy, MRI scheduled |
|
| VAERS ID: |
1951967 (history) |
| Form: |
Version 2.0 |
| Age: |
8.0 |
| Sex: |
Male |
| Location: |
Washington |
| Vaccinated: | 2021-12-07 |
| Onset: | 2021-12-09 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-15 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 2 |
LA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Brain natriuretic peptide increased,
C-reactive protein normal,
Chest X-ray normal,
Electrocardiogram normal,
Myocarditis,
Troponin increased SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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? Yes, 3 days
Extended hospital stay? No Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: atopic dermatitis Allergies: none noted Diagnostic Lab Data: High sensitivity troponin 6964 12/11, to 3014 12/12/21, to 690 12/13/2021 pro BNP 396 12/11, 199 12/13 CDC Split Type:
Write-up: post vaccine myocarditis, symptoms 2 days after vaccination, came in the morning of 12/10. CXR and EKG normal, CRP 1.1 (mildly elevated) troponin 7.94 (elevated. Admitted to a local Hospital |
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| VAERS ID: |
1970417 (history) |
| Form: |
Version 2.0 |
| Age: |
9.0 |
| Sex: |
Male |
| Location: |
Oregon |
| Vaccinated: | 2021-11-18 |
| Onset: | 2021-11-23 |
| Days after vaccination: | 5 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: School Purchased by: ? Symptoms: Angina pectoris,
Arthralgia,
Blood test,
Chest X-ray,
Chest pain,
Dyspnoea,
Echocardiogram abnormal,
Electrocardiogram,
Exercise tolerance decreased,
Headache,
Inflammatory marker increased,
Loss of personal independence in daily activities,
Pericarditis,
Pulmonary pain SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: 12/11/21 echocardiogram ekg blood panel tests 2 chest xrays CDC Split Type:
Write-up: Started 5 days after 1st vaccine with headaches then severe joint pain that lasted for 5 days then the heart and chest pain started and has been going on now for 4 weeks. We went to urgent care the er and pediatrician. He had high levels of inflammatory marker and after a echocardiogram the ER doctor said most likely pericarditis. Pain in chest and lungs worse when laying down. My 9 you cannot walk long distances or at a fast pace cannot play and had been taking ibuprofen on and off for almost 4 weeks now. It is NOT heart burn because antacids do not help his shortness of breath and chest pain. |
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| VAERS ID: |
1974324 (history) |
| Form: |
Version 2.0 |
| Age: |
5.0 |
| Sex: |
Male |
| Location: |
Maryland |
| Vaccinated: | 2021-11-13 |
| Onset: | 2021-11-01 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-12-23 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
LA / - |
Administered by: Other Purchased by: ? Symptoms: Body temperature,
Chest pain,
Dyspnoea,
Electrocardiogram,
Fatigue,
Heart rate irregular,
Pericarditis,
Pyrexia,
SARS-CoV-2 test SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad), Noninfectious myocarditis/pericarditis (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
Extended hospital stay? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None Allergies: Diagnostic Lab Data: Test Date: 20211209; Test Name: Fever; Result Unstructured Data: Test Result:102; Test Name: ECG; Result Unstructured Data: Test Result:Irregular heartbeat; Test Name: EKG; Result Unstructured Data: Test Result:Irregular heartbeat; Test Date: 20211209; Test Name: COVID PFIZER 2 PED 5-11; Test Result: Negative ; Comments: Nasal Swab CDC Split Type: USPFIZER INC202101771761
Write-up: possible pericarditis; chest pain; feeling tired; harder to breath than normal; irregular heartbeat; fever hovering at 102 for 3 days; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). A 5 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 13Nov2021 09:45 (Batch/Lot number: unknown) at the age of 5 years as dose 1, single for covid-19 immunisation. The patient had no relevant medical history. The patient had no known allergies. The patient was not diagnosed with COVID prior vaccination. There were no concomitant medications in two weeks. The patient did not receive any other vaccination within the four weeks before the vaccination. Facility where the most recent COVID-19 vaccine was administered: Doctor''s office/urgent care. The following information was reported: PERICARDITIS (hospitalization) with onset 16Nov2021 14:00, outcome "recovering", described as "possible pericarditis"; CHEST PAIN (hospitalization) with onset 16Nov2021 14:00, outcome "recovering", described as "chest pain"; FATIGUE (hospitalization) with onset 16Nov2021 14:00, outcome "recovering", described as "feeling tired"; DYSPNOEA (hospitalization) with onset 16Nov2021 14:00, outcome "recovering", described as "harder to breath than normal"; HEART RATE IRREGULAR (hospitalization) with onset 16Nov2021 14:00, outcome "recovering", described as "irregular heartbeat"; PYREXIA (non-serious) with onset Nov2021, outcome "recovering", described as "fever hovering at 102 for 3 days". The patient was hospitalized for pericarditis, chest pain, fatigue, dyspnoea, heart rate irregular (hospitalization duration: 1 day(s)). The events "possible pericarditis", "chest pain", "feeling tired", "harder to breath than normal" and "irregular heartbeat" were evaluated at the emergency room visit. The patient underwent the following laboratory tests and procedures: electrocardiogram: (unspecified date) irregular heartbeat; (unspecified date) irregular heartbeat; body temperature: (09Dec2021) 102; sars-cov-2 test: (09Dec2021) negative, notes: Nasal Swab. Therapeutic measures were not taken as a result of pericarditis, chest pain, fatigue, dyspnoea, heart rate irregular, pyrexia. Clinical course: Child was taken in ambulance to hospital. Emergency medical technician (EMT) found irregular heartbeat on Electrocardiogram (EKG)/ Electrocardiogram (ECG). Same was found in hospital. Released with possible pericarditis and request to follow up with pediatrician for chest x-ray and covid test (which was negative). A week later, he had a fever hovering at 102 for 3 days. The lot number for bnt162b2 was not provided and will be requested during follow up. |
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