VAERS ID: 1334563

AGE: 15| SEX: M|STATE: WA (United States)

Description

Recevied vaccine on 5/14 around 6 pm. Started noticing chest pain, chills and fatigue on 5/15 around 6 pm. Evaluated by ED on 5/17 subsuquently admitted to PICU with intermittent chest pain and elevated troponin in the setting of recent Covid vaccination as well as a history of WPW status post ablation with recent onset of intermittent tachycardia. EKG demonstrates nonspecific ST segment changes and has elevated troponin which likey points to myocarditis as a diagnosis. Continues with elevated troponin level, no medication intervention at this time, no longer having chest pain

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Symptoms

Chills, Tachycardia, Chest pain, Electrocardiogram abnormal, Myocarditis, Fatigue, Intensive care, C-reactive protein increased, Troponin increased, Electrocardiogram ST segment abnormal, Respiratory viral panel, SARS-CoV-2 test negative, SARS-CoV-2 antibody test positive

Vaccines

VAX DATE: 05-14-2021| ONSET DATE: 05-15-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 2 COVID19 MODERNA 002c21a IM LA
HPV (GARDASIL 9) 2 HPV9 MERCK & CO. INC. 1691180 IM RA

RECVDATE:05-20-2021
RPT_DATE:
CAGE_YR:15
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Troponin 16.72 (5/19), CRP 10.6 (5/19), COVID-19 IgG Ab positive (5/17), SARS-CoV2 NP swab not detected (5/17), Viral Respiratory PCR negative (5/18)
V_ADMINBY:PHM
OTHER_MEDS:none
CUR_ILL:none
HISTORY:past history of Wolff-Parkinson-White (WPW) sp ablation 2019
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:05-20-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:none
V_FUNDBY:

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