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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1471280

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Case Details

VAERS ID: 1471280 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood chloride normal, Blood glucose normal, Blood potassium normal, Blood sodium decreased, Blood urea normal, C-reactive protein increased, Carbon dioxide increased, Chest discomfort, Chest pain, Eosinophil percentage, Full blood count, Haematocrit normal, Haemoglobin normal, Lymphocyte percentage increased, Malaise, Mean cell volume normal, Monocyte percentage increased, Myocarditis, Nausea, Neutrophil percentage decreased, Platelet count normal, Troponin increased, Vomiting, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic leukopenia (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), 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), Infective pneumonia (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: None
Preexisting Conditions: Autism Spectrum disorder and Speech delay
Allergies: nka
Diagnostic Lab Data: 07/13/21 2313 NA 135 K 3.5 CO2 30 CL 97* BUN 11 CR 0.46 RBS 106 CBC Recent Labs 07/13/21 1554 WBC 5.8 HGB 14.8 HCT 41.2 PLT 273 MCV 81 NEUT 46 LYMPH 41 MONO 11 EOS 1 Cardiac Recent Labs 07/14/21 1130 07/14/21 0543 07/13/21 2313 TROP 8.20* 7.57* 11.05* Results as of 7/14/2021 17:40 7/13/2021 15:54 CRP, SER QL: 1.0 (H) 7/13/2021 23:13 CRP, SER QL: 0.9 7/14/2021 11:30 CRP, SER QL: 0.6
CDC Split Type:

Write-up: 12 Y 4 M old male with a history of chest pain that started two days ago on Monday. On 7/11 night, he didn''t feel well felt nauseous. He was able to sleep but had chest pain the following morning that improved after he vomited. The chest pain is midsternal and feels pressure-like. It lasted a few hours. He swam on 7/12 without problems (at a swim club) for an hour. He had his second dose of COVID-19 vaccine on Saturday 7/10/21. There has not been any fevers. Elevated troponin and CRP with recent COVID-19 vaccine, suspicious for post-vaccine myocarditis. He is hemodynamically stable with normal vitals and no evidence of ventricular ectopy or depressed left ventricular function. His troponin peaked at 11.05 and trended down, but his most recent value is slightly up at 8.2 from 7.6. Recommended continuing to trend the troponins for now (if they show a downward trend then twice daily is adequate, unless he develops chest pain). At this time, IVIG is held unless he becomes unstable or the troponins trend upward .


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