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

Found 529 cases where Age is under-18 and Vaccine is COVID19 and Hospitalized and Vaccination Date from '2021-06-01' to '2021-06-30'



Case Details

This is page 26 out of 53

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VAERS ID: 1413589 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Asthenia, Blood culture, Blood lactic acid normal, Brain natriuretic peptide normal, C-reactive protein increased, Chest X-ray normal, Computerised tomogram head normal, Drooling, Eye movement disorder, Full blood count normal, International normalised ratio normal, Metabolic function test normal, Prothrombin time normal, Pyrexia, Seizure like phenomena, Tremor, Troponin normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fish oil, multivitamin with fluoride, Nasonex nasal spray
Current Illness: N/A
Preexisting Conditions: Autism and remote history of asthma
Allergies: Dog Hair, Peanut Butter Flavor, Tree Nuts
Diagnostic Lab Data: Patient had a chest x-ray which was negative and a head CT which was negative for any intracranial pathology. His CBC, CMP, BNP, troponin, lactate, PT, PTT, INR were unremarkable, blood culture was drawn, CRP elevated to 12.2. He did not receive any abortive medications and did not have any further seizure-like activity. He was transported to ED for further work-up and hydration.
CDC Split Type:

Write-up: On 06/19/2021 was noted to have decreased energy and temp was ~100, tylenol given. A few hours later after completing his morning therapies he showered and went to take a nap. At this time he was febrile to 103.6. At 1600 he had seizure-like activity with trunk and upper extremity shaking as well as eyes rolling back and drooling. Parents put him in car and transported him to an outside hospital. He did stop seizing prior to getting to that hospital. Parents reported seizure lasted approximately 15 minutes with no loss of bowel or bladder control. By time he arrived at local emergency room he was back at his neurological baseline. At the outside hospital our PICU was consulted and he was given ceftriaxone and vancomycin in meningitic dosing.


VAERS ID: 1413830 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein increased, Cardiac telemetry, Chest pain, Echocardiogram normal, Electrocardiogram normal, Troponin increased, Ventricular extrasystoles
SMQs:, Myocardial infarction (narrow), Ventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypokalaemia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: His troponin peaked at 7.8, and waxed and waned over his stay. On day three, it steadily decreased to 1.2. CRP was also elevated with a max at 5.3, but was <1 on discharge. He remained on telemetry throughout his stay, and had occasional pvcs but no true ectopy. Two echos and multiple EKGs were normal. His chest pain resolved by HD 2 and he felt well after that. He was started on high dose ibuprofen and pepsid, which he should remain on for a total of 7 days.


VAERS ID: 1414308 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram abnormal, Electrocardiogram abnormal, Left ventricular dysfunction, Troponin
SMQs:, Cardiac failure (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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:
Allergies:
Diagnostic Lab Data: evidence of ECG abnormalities, significant troponin leak and mild to moderate LV dysfunction on echo.
CDC Split Type:

Write-up: Chest pain, evidence of ECG abnormalities, significant troponin leak and mild to moderate LV dysfunction on echo.


VAERS ID: 1414580 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-15
Onset:2021-06-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Intensive care, Multisystem inflammatory syndrome in children, Myocarditis, Pain in jaw, Pyrexia, Vaccination complication, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concerta 40 mg by mouth daily Trileptal 150 mg by mouth daily Wellbutrin 150 mg by mouth daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 13 yo previously healthy x ADD, takes Trileptal, Welbutrin, Concerta and Latuda, received second Pfizer Covid vaccine 2 days ago. This morning, began with atraumatic mid-sternal chest pain. Pain is constant, not affected by position - ie no change with sitting/supine/standing. + fever to 100.5 tonight. + emesis x 1. Also had jaw pain that resolved after motrin. No cough, rash, diarrhea. CHEST PAIN - MYOCARDITIS secondary to rare complication of Covid Vaccine vs MIS-C Transport PICU nurse - spoke with Peds ED physician - they recommend IV and labs to evaluate for possible MIS-C.


VAERS ID: 1414674 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-11
Onset:2021-06-21
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Carbon dioxide decreased, Diabetic ketoacidosis, Glycosylated haemoglobin increased, Lethargy, Pollakiuria, Sluggishness
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol and loratadine
Current Illness: None
Preexisting Conditions: intermittent asthma
Allergies: NKA
Diagnostic Lab Data: CO2<10 A1C 13.4
CDC Split Type:

Write-up: Diabetic ketoacidosis CO2<10 A1C 13.4 Weak/sluggish/lethargic,/urinating a lot


VAERS ID: 1415059 (history)  
Form: Version 2.0  
Age: 0.25  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bacterial test negative, Blood glucose normal, Computerised tomogram normal, Electroencephalogram normal, Exposure via breast milk, Lumbar puncture normal, Magnetic resonance imaging normal, Seizure, Viral test negative
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Neonatal exposures via breast milk (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Bacterial/viral tests came back negative June 21 Glucose came back negative June 19 Two EEG tests came back normal. June 19&20 MRI/CT scans came back normal. June 19th Spinal test came back normal. June 21
CDC Split Type:

Write-up: I (mother of patient ) received the first dose of the Moderna vaccine on Friday June 18th at approximately 01:30pm. I fed my three month old daughter milk that I pumped from my breasts later that night and put her to bed. When transferring her to her bassinet at approximately 11:30pm, she started a seizure that lasted seven minutes. We were transported to Hospital where she suffered two more seizures in the early morning hours of June 19th. She has been a healthy baby with no health conditions prior to these events.


VAERS ID: 1415092 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Cardiac imaging procedure abnormal, Chest pain, Electrocardiogram ST segment elevation, Pericarditis, Red blood cell sedimentation rate increased, Troponin
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 6/20/21 Troponin: 1.39 6/20/21 EKG with diffuse ST segment elevation (by report) 6/20/21 CRP: 4.62 6/20/21 ESR: 21 6/21/21 Cardiac MRI: Pericarditis, no evidence of myocarditis
CDC Split Type:

Write-up: He developed chest pain two days after vaccination. The chest pain was worse with laying flat.


VAERS ID: 1415191 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-13
Onset:2021-06-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Conduction disorder, Echocardiogram normal, Electrocardiogram abnormal, Myocarditis, QRS axis abnormal, Sinus arrhythmia, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Conduction defects (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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: ECG demonstrated normal sinus rhythm with sinus arrhythmia, left axis deviation (mild) , and non-specific intra-ventricular conduction delay. Echocardiogram impression: 1. Normal-size right ventricle; no evidence of right ventricular hypertrophy; qualitatively normal right ventricular systolic function. 2. Normal-size left ventricle; normal left ventricular wall thickness; normal left ventricular systolic function - LV FS (2D) = 36 %, z = 0.4 - LV EF (AL) = 68 % - LV global longitudinal strain (triplane) = -20.4 %. 3. Normal cardiac valve morphology and function. 4. No pericardial effusion.
CDC Split Type:

Write-up: Patient is a 14 year old male without significant past medical history presenting with chest pain and elevated troponin consistent with myocarditis after second COVID vaccine administration. His troponin level peaked at 4.0 mg/mL. Chest pain resolved prior to discharge. ECG and Echocardiogram results below, both overall unremarkable.


VAERS ID: 1415193 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Cough, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Pyrexia, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity (BMI 32)
Allergies: None
Diagnostic Lab Data: -ECG on presentation with ST segment elevation, this normalized by hospital day 3 -Troponin level on admission was 10.6 and peaked to 12.9 (hospital day 2) and decreased to 6.5 on day of discharge (6/8) - echocardiogram normal - CRP 4; ESR 18 - Coxsackie virus B PCR 1:8 (repeat labs pending) - Other respiratory viral panel, other viral studies normal; COVID-19 PCR negative
CDC Split Type:

Write-up: 2 days after vaccine, reported to have fever (unsure what temp). 3 days post vaccine, chest pain worse when lying down and dry cough. On that day, seen in ER with abnormal ECG (ST segment elevation) and elevated troponin level. Transferred and admitted to my hospital. Given ibuprofen for chest pain which improved quickly. Reassuring cardiac findings and improved troponin and ECG and discharged to home on hospital day 3. See below for labs


VAERS ID: 1415290 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-16
Onset:2021-06-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LOT: EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, C-reactive protein increased, Chest pain, Chills, Cytomegalovirus test, Echocardiogram, Electrocardiogram abnormal, Epstein-Barr virus test, Immunoglobulin therapy, Magnetic resonance imaging heart, Myocarditis, Orthopnoea, Pain, Pyrexia, QRS axis abnormal, Red blood cell sedimentation rate increased, Respiratory viral panel, Sinus tachycardia, Troponin increased, Vaccination complication
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (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? 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: severe allergic reaction to cat and pollen h/o tonsillectomy and adenoidectomy
Allergies: cat, pollen
Diagnostic Lab Data: EKG sinus tachy with left axis deviation. Troponin 14-$g13-$g 16 CRP 1.7 ESR 17 echo and cardiac MRI in process respiratory viral panel and CMV, EBV in process
CDC Split Type:

Write-up: Fever and chills onset 12 hours after shot. Then chest pain radiating to axilla worsening with exertion with associated orthopnea onset 6/18, aprx two days after shot. Admitted on 6/20/21 with elevated troponin to 16, with suspected covid vaccine related myocarditis. He is getting IVIG and ketorolac. Pt is stable now without any EKG interval changes, EKG sinus tachy with left axis deviation.


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