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This is VAERS ID 1500847

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/30/2021

VAERS ID: 1500847
VAERS Form:2
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:2021-07-16
Onset:2021-07-21
Submitted:0000-00-00
Entered:2021-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Military      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Echocardiogram, Myocarditis, Left ventricular dysfunction, Magnetic resonance imaging heart

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cardiac MRI 7/22 Cardiac echo 7/23
CDC 'Split Type':

Write-up: Myocarditis. Patient presented with chest pain and SOB 5-6 days after receiving vaccine #1. Found to have myocarditis with depressed LV function

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