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From the 9/17/2021 release of VAERS data:

Found 917 cases where Age is 12-or-more-and-under-20 and Vaccine targets COVID-19 (COVID19) and Symptom is Acute endocarditis or Atypical mycobacterium pericarditis or Autoimmune myocarditis or Bacterial pericarditis or Carditis or Endocarditis or Endocarditis bacterial or Endocarditis enterococcal or Endocarditis noninfective or Endocarditis staphylococcal or Endocarditis viral or Eosinophilic myocarditis or Fungal endocarditis or Giant cell myocarditis or Immune-mediated myocarditis or Lupus endocarditis or Lyme carditis or Meningococcal carditis or Myocarditis or Myocarditis bacterial or Myocarditis infectious or Myocarditis septic or Myopericarditis or Pericarditis or Pericarditis constrictive or Pericarditis infective or Pericarditis lupus or Pericarditis meningococcal or Pericarditis rheumatic or Pericarditis tuberculous or Pleuropericarditis or Purulent pericarditis or Streptococcal endocarditis or Subacute endocarditis or Viral myocarditis or Viral pericarditis

Table

   
Event OutcomeCountPercent
Death10.11%
Permanent Disability192.07%
Office Visit18820.5%
Emergency Doctor/Room33936.97%
Hospitalized71678.08%
Hospitalized, Prolonged10.11%
Recovered28330.86%
Birth Defect10.11%
Life Threatening10911.89%
Not Serious525.67%
TOTAL† 1,709† 186.37%
† Because some cases have multiple vaccinations and symptoms, a single case can account for multiple entries in this table. This is the reason why the Total Count is greater than 917 (the number of cases found), and the Total Percentage is greater than 100.



Case Details

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VAERS ID: 953557 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2020-12-30
Onset:2020-12-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / OT

Administered by: Senior Living       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Myocarditis; A spontaneous report was received from a physician, concerning a 18-year-old, male patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced myocarditis. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 30 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot number: 037K20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 31 Dec 2020, within 24 hours of vaccine administration, the patient develop symptoms of myocarditis and was admitted to the hospital. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome for the event, myocarditis, was not reported.; Reporter''s Comments: This case concerns an 18-year-old, male, who experienced a serious unexpected event of myocarditis. The event occurred approximately 2 days after first dose of mRNA-1273, Lot# 037K20A administration. No information available regarding medical history and concomitant medications. Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1071409 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-21
Onset:2021-02-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Blood creatine phosphokinase MB increased, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Headache, Pericarditis, Pyrexia, Troponin T increased, Troponin increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obesity
Allergies: none
Diagnostic Lab Data: The patient was found to have significantly elevated Troponins and elevated CKMB. His troponin and CKMB down trended during his admission. Echocardiogram was performed to show no significant abnormalities. EKG changes noted were diffuse ST segment elevations, which persisted throughout his entire hospital stay. Troponin T Latest Ref Range: <=0.03 ng/mL 2/25/2021 03:33 : 2.54 (H) 2/25/2021 10:10 : 2.92 (H) 2/25/2021 17:55 : 3.38 (H) 2/26/2021 03:15 : 3.27 (H) 2/26/2021 10:15 : 2.57 (H) 2/26/2021 17:56 : 2.39 (H) 2/27/2021 02:00 : 2.01 (H) 2/27/2021 10:45: 2.02 (H) CKMB Latest Ref Range: 0.0 - 7.5 ng/mL 2/25/2021 03:33 - 123.4 (H) 2/25/2021 10:10 - 104.1 (H) 2/25/2021 17:55 - 63.7 (H) 2/26/2021 03:15 - 25.9 (H) 2/26/2021 10:15 - 17.3 (H) 2/26/2021 17:56 - 9.7 (H) 2/27/2021 02:00 - 5.8 2/27/2021 10:45 - 4.9 Echo 2/25 1. This was a technically difficult study, possibly affecting interpretation. 2. Normal segmental cardiac anatomy. 3. Normal right ventricular systolic shortening. 4. Left ventricular systolic function was low normal. 5. No evidence of elevated pulmonary artery pressure ECG 2/25 Normal sinus rhythm Low voltage QRS, consider pulmonary disease, pericardial effusion, or normal variant ST elevation consider inferolateral injury or acute infarct ** ** ACUTE MI / STEMI ** ** Abnormal ECG ECG: 2/26 Normal sinus rhythm Low voltage QRS, consider pulmonary disease, pericardial effusion, or normal variant ST elevation consider lateral injury or acute infarct ** ** ACUTE MI / STEMI ** ** Abnormal ECG
CDC Split Type:

Write-up: Since receiving his second dose of COVID-19 vaccine (Pfizer) on Sunday 2/21 he has had fever (tmax 103.0 F), headache, and stomach ache. His fever started on 2/21 and had persisted through 2/24. He woke up from a nap on 2/24 in the afternoon at 1600 had onset of severe chest pain. Then reoccurring multiple times throughout the evening. He was taken to a local hospital and the transferred to another hospital for higher level of care. Pediatric cardiology was consulted and treatment was started for suspected atypical pericarditis with colchicine 0.6mg BID and ibuprofen 600mg QID w/ famotidine 40mg QDay. His chest pain resolved the day of admission, even prior to starting treatment. Patient was discharged in clinically stable condition to follow up with pediatric cardiology in 2 weeks as outpatient.


VAERS ID: 1077643 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-02-19
Onset:2021-02-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac, Chest pain, Echocardiogram, Electrocardiogram, Myocardial infarction, Myocarditis
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sertriline, buspirone
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Shellfish
Diagnostic Lab Data: Bloodwork, EKGs, ECHO, heart cath,
CDC Split Type:

Write-up: Originally seen for chest pain later learned it was a Heart attack and myopericarditis


VAERS ID: 1081208 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-04
Onset:2021-03-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cold sweat, Electrocardiogram ST segment elevation, Human rhinovirus test positive, Malaise, Myocarditis, Nausea, Pain, Pericarditis, Pyrexia, SARS-CoV-2 test negative, Sleep disorder, Troponin increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

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: Albuterol inhaler
Current Illness: diagnosed in ED with Rhinovirus
Preexisting Conditions: Asthma
Allergies: Gluten, Legumes
Diagnostic Lab Data: Molecular testing was negative for COVID-19 but positive for a rhinovirus. His troponin was initially elevated to 11.98. A subsequent troponin reached 22. Pt was transferred medical facility for cardiac MRI. Final diagnosis at medical center: Pericarditis, myocarditis, positive rhino virus testing
CDC Split Type:

Write-up: This is a 18 y.o. male who is generally healthy. He received a second dose of the SARS2-COV vaccine on 3/4. The following morning he felt feverish and achy with malaise. He stayed home, drank fluids and rested and felt well enough to come up to ski this weekend. During skiing he had some anterior chest pain, it resolved and he went about his day. Tonight at 2245 the pain became sharp and awakened him from sleep. He felt nauseated and clammy as well. Father brought him to the ER for evaluation. His emergency department evaluation showed ST elevations most notably in the inferior and lateral leads as well as in the lateral precordium.


VAERS ID: 1086883 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-02-16
Onset:2021-02-22
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 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)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Medical History/Concurrent Conditions: No adverse event (No reported medical history.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Perimyocarditis post covid19 vaccine syndrome; A spontaneous report was received from a physician concerning a 19 year old, male patient, who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced perimyocarditis post covid19 vaccine syndrome. The patient''s medical history was not provided. No concomitant medications were reported. On 16 Feb 2021, approximately six days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number: 013L20A) for prophylaxis of COVID-19 infection. On 22 Feb 2021 the patient experienced the symptoms following vaccination: perimyocarditis post covid19 vaccine syndrome. No treatment information was provided. No relevant laboratory details were included. The seriousness criteria for the event perimyocarditis post covid19 vaccine syndrome were hospitalization and medically significant. Action taken with the drug in response to the event was unknown. The outcome of the event, perimyocarditis post covid19 vaccine syndrome was reported resolved on an unknown date.; Reporter''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1126793 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-18
Onset:2021-03-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Hypokinesia, Myocarditis, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Trop peak 16, EKG will Diffuse ST elevation. Echo shows global hypokinesis, reduced EF ~45%.
CDC Split Type:

Write-up: Chest Pressure developed 2 days post-vaccine. Admitted for elevated troponins, myopericarditis. Improved on NSAIDs, colchicine.


VAERS ID: 1141993 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-02-08
Onset:2021-02-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Acute myocardial infarction, Angiogram normal, Blood test abnormal, Chest X-ray, Chest pain, Echocardiogram normal, Electrocardiogram normal, Headache, Heart rate increased, Impaired work ability, Myocarditis, Nausea, Pain, Troponin increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Elevated Troponin levels of 9585.8 ng/L in my blood. EKG, Echocargiogram, and CT Angiogram showed normal results
CDC Split Type:

Write-up: At 2-8-21 at approximately 1:00pm I recieved my 2nd shot. At 5:00am on 2-9-21, I woke up experiencing an extreme headache, nausea, body aches, and severe chest pain. I checked my heartrate with a PulseOximeter and found it to be elevated at 105-115. I called out of work and rested in bed for the day. On 2-10-21 most of my symptoms had subsided however the chest pain persisted through 2-11-21. On 2-11-21 at 2:00pm, I visited the Urgent Care. While there, the provider ran an ECG, Chest X-Ray, and bloodwork. Test results showed Troponin levels in my blood had reached critical levels of 7.72ng/ml. I was immediately transported to the ER at the Hospital, where upon arrival they did an EKG and bloodwork. I was then admitted and seen by a cardiologist, who ordered an CT Angiogram, more bloodwork, and an Echocardiogram. After I was admitted, my mother contact the nurses station to check on me and asked what was wrong. She was then told the hospital was treating me for an NSTEMI and Myocarditis. This resulted in a 3 day hospital stay where the results of the tests showed there was nothing wrong with my heart other than the increased Troponin levels. It should be noted that I have had ZERO previous cardiac issues, or any other significant health issues. I was discharged from the hospital with lower but still elevated Troponin levels, and told to follow up with my primary care doctor. I had no health issues and felt fine until I had my second dose of the Covid-19 vaccine. I have copies of my hospital records detailing all of this.


VAERS ID: 1147032 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute left ventricular failure, Blood creatine phosphokinase increased, Cardiogenic shock, Chest pain, Dizziness, Dyspnoea, Ejection fraction, Fatigue, Muscle necrosis, Myocarditis, Nausea, Pain, Pulmonary oedema, Pyrexia, Respiratory failure, Troponin increased, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (narrow), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg PO daily Cyclobenzaprine 10mg PO Q8H PRN Montelukast 10mg PO daily
Current Illness: None
Preexisting Conditions: None
Allergies: Ketorolac
Diagnostic Lab Data: 3/28 0909 CPK 388 U/L 3/28 1431 CPK 2334 U/L 3/29 0803 CPK 1273 U/L 3/28 0440 Troponin (T) 1438 ng/L 3/28 0738 Troponin(T) 2118 ng/L 3/28 1814 Troponin(T) 3064 ng/L 3/29 0527 Troponin(T) 2644 ng/L 3/30 0800 Troponin(T) 2824 ng/L 3/28 0900 Echo EF 38%
CDC Split Type:

Write-up: Pt reports generalized body aches, fatigue, fever 3/26, one day after receiving vaccine. Evaluated at ED 3/28, received Ketorolac and was discharged. While in parking lot, patient experienced blurring of vision, lightheadedness, nausea, SOB, and left-sided chest pain with return for re-evaluation. Pt treated for possible allergic reaction and concurrent EKG and blood work showed elevated troponin and transient ST elevation. Cardiology consulted and evaluated patient to have severe acute onset systolic heart failure, cardiogenic shock with pulmonary edema, Idiopathic fulminant myocarditis with myonecrosis, and hypoxic respiratory failure. Placed on furosemide, supplemental oxygen, and pending MRI.


VAERS ID: 1148316 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Antinuclear antibody negative, Blood thyroid stimulating hormone decreased, Borrelia test, Brain natriuretic peptide increased, Chest pain, Condition aggravated, Coxsackie virus test, Cytomegalovirus test negative, Dizziness, Drug screen negative, Electrocardiogram abnormal, HIV test negative, Immunology test, Leukocytosis, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart, Myocarditis, Parvovirus B19 test negative, Thrombocytosis, Thyroxine free normal, Treponema test negative, Tri-iodothyronine free normal, Troponin increased, Viral test negative
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PREVIOUS HISTORY OF CHEST PAIN AND ELEVATED LIVER ENZYMES 3 YEARS AGO
Allergies: NONE
Diagnostic Lab Data: TROPONIN ON ADMISSION WAS 1500$g$g200s UDS NEG ANA, HIV, CMV, SYPHILLIS, VIRAL PANEL ALL NEG PARVO NEG COXSACKIE AND LYME PENDING TSH LOW, FREE T3 AND T4 NORMAL BNP 147$g140$g111 LEUKOCYTOSIS AND THROMBOCYTOSIS IMPROVED EKG ABNORMAL EF 65-69% MRI CONSISTENT WITH MYOCARDITIS
CDC Split Type:

Write-up: BEGAN FEELING CHEST PAIN AND LIGHTHEADEDNESS BEGINNING 3/14, THE DAY AFTER GETTING THE VACCINE. HE PRESENTED TO THE EMERGENCY ROOM ON 3/17 WITH WORSENING OF CP THAT WOULD NOT GET BETTER WITH NSAIDS, PAIN RADIATING DOWN LEFT ARM. TROPONINS NOTED TO BE ELEVATED, PT ADMITTED TO INPATIENT ROOM FOR CARE ON 3/17. TESTING DONE AND PT TREATED FOR MYOCARDITIS POSSIBLY SECONDARY TO COVID 19 VACCINATION. DC''D HOME ON 3/24 WITH LISINOPRIL AND PREDNISONE. ORDERS TO FOLLOW UP WITH DR.


VAERS ID: 1172292 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Catheterisation cardiac normal, Chest pain, Dyspnoea, Echocardiogram abnormal, Malaise, Myocardial necrosis marker increased, Neck pain, Pain in extremity, Pericarditis, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergies to peanuts, legumes, tree nuts. Last had epinephrine 8 years ago.
Allergies: Peanuts, Tree nuts, Legumes, Sulfa
Diagnostic Lab Data: 4/6/2021 Cardiac catheterization Clinic
CDC Split Type:

Write-up: Received Jansen COVID injection at approximately 11am 4/3/2021. Developed sore left arm, shoulder, and neck approximately 10 pm evening of 4/3/2021. Woke up 3:30am 4/4/2021 and informed parents he did not feel well-awake most of that night. Felt slightly better morning of 4/4/2021, but continued feeling feverish, pain in arms, shoulders, neck. Approximately 8pm Sunday night 4/4/21 he stated he felt it was hard to breath, chest pain, and his arms felt like they were on fire. Was taken to ER at Clinic. Blood pressure 149/98, temp 100.6 complain of feeling feverish and short of breath. EKG was taken which was abnormal and enzymes noted to be elevated. Transferred to main branch of Clinic approximately 4:30am 4/5/2021. Father states patient has inflammation around the heart. Had a cardiac catheterization today 4/6/2021-father states that was normal and patient was started on medication to reduce inflammation around his heart. Patients father states that patient was very drowsy from his catheterization and was fine with his father telling me the events as they occured. As I was speaking with patient father, patient was going down for a MRI of the heart. This information was conveyed to me by father and mother. Patient is a college student and was home for Easter break. Patient currently remains hospitalized in Clinic and father thought he would remain hospitalized until Thursday 4/8/2021 depending on test results and his response to treatment. Both parents state they are willing to be contacted for further information.


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https://medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=CAT&EVENTS=ON&SYMPTOMS[]=Acute+endocarditis+%2810049001%29&SYMPTOMS[]=Atypical+mycobacterium+pericarditis+%2810055036%29&SYMPTOMS[]=Autoimmune+myocarditis+%2810064539%29&SYMPTOMS[]=Bacterial+pericarditis+%2810004050%29&SYMPTOMS[]=Carditis+%2810062746%29&SYMPTOMS[]=Endocarditis+%2810014665%29&SYMPTOMS[]=Endocarditis+bacterial+%2810014666%29&SYMPTOMS[]=Endocarditis+enterococcal+%2810014671%29&SYMPTOMS[]=Endocarditis+noninfective+%2810062608%29&SYMPTOMS[]=Endocarditis+staphylococcal+%2810014684%29&SYMPTOMS[]=Endocarditis+viral+%2810061837%29&SYMPTOMS[]=Eosinophilic+myocarditis+%2810014961%29&SYMPTOMS[]=Fungal+endocarditis+%2810017529%29&SYMPTOMS[]=Giant+cell+myocarditis+%2810083635%29&SYMPTOMS[]=Immune-mediated+myocarditis+%2810082606%29&SYMPTOMS[]=Lupus+endocarditis+%2810058225%29&SYMPTOMS[]=Lyme+carditis+%2810078417%29&SYMPTOMS[]=Meningococcal+carditis+%2810027270%29&SYMPTOMS[]=Myocarditis+%2810028606%29&SYMPTOMS[]=Myocarditis+bacterial+%2810065218%29&SYMPTOMS[]=Myocarditis+infectious+%2810066857%29&SYMPTOMS[]=Myocarditis+septic+%2810028615%29&SYMPTOMS[]=Myopericarditis+%2810028650%29&SYMPTOMS[]=Pericarditis+%2810034484%29&SYMPTOMS[]=Pericarditis+constrictive+%2810034487%29&SYMPTOMS[]=Pericarditis+infective+%2810062491%29&SYMPTOMS[]=Pericarditis+lupus+%2810058149%29&SYMPTOMS[]=Pericarditis+meningococcal+%2810034492%29&SYMPTOMS[]=Pericarditis+rheumatic+%2810034496%29&SYMPTOMS[]=Pericarditis+tuberculous+%2810055069%29&SYMPTOMS[]=Pleuropericarditis+%2810059361%29&SYMPTOMS[]=Purulent+pericarditis+%2810051071%29&SYMPTOMS[]=Streptococcal+endocarditis+%2810073742%29&SYMPTOMS[]=Subacute+endocarditis+%2810042276%29&SYMPTOMS[]=Viral+myocarditis+%2810047470%29&SYMPTOMS[]=Viral+pericarditis+%2810047472%29&VAX=COVID19&VAXTYPES=COVID-19&WhichAge=range&LOWAGE=12&HIGHAGE=20


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