National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

From the 1/7/2022 release of VAERS data:

This is VAERS ID 1493763

Government Disclaimer on use of this data

Case Details

VAERS ID: 1493763 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Montana  
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: ?
Symptoms: C-reactive protein increased, Cardiac imaging procedure abnormal, Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Fatigue, Immediate post-injection reaction, Immunoglobulin therapy, Left ventricular dysfunction, Myocarditis, Palpitations, Pericardial effusion, Right ventricular dysfunction, Right ventricular ejection fraction decreased, Troponin increased
SMQs:, Cardiac failure (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Hypersensitivity (narrow), 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? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Melatonin
Current Illness: None
Preexisting Conditions: Autism Spectrum Disorder
Allergies: Amoxicillin
Diagnostic Lab Data: 7/17 Troponin 20,987 at 1450 and CRP 79.4. 7/17 Troponin 28,338 at 2336. 7/18 Troponin 23376, CRP 53. 7/19 Troponin 19,463, CRP 29. 7/20 Troponin 4,658, CRP 16.6. 7/21 Troponin 2,076, CRP 9.3. 7/17 Echo - LVEF 40-50%, with LV+RV mildly depressed systolic function + diastolic function. 7/19 Echo- LVEF 50%, low-normal function, slightly improved. 7/19 Cardiac MRI - Mildly decreased global LV systolic function (EF 47%), decreased RV systolic function (EF 37%), small pericardial effusion. 7/21 Echo normal.
CDC Split Type:

Write-up: Chest pain and palpitations, fatigue immediately post vaccine and chest pain starting 43 hours later. Admitted at 48 hours with troponin 20,000 and decreased biventricular function on echo (RVEF 37%) consistent with myocarditis. Symptomatic improvement post IVIG treatment. Hospital stay 4 days without arrhythmia or other events. Treated with IVIG alone.

New Search

Link To This Search Result:

Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166