VAERS ID: 1344363

AGE: 17| SEX: M|STATE: WA (United States)

Description

17 y/o M with no PMHx presenting to ED from another ED for work-up of acute onset chest pain. Patient experienced this pain at approximately 2200 on 5/23 and this prompted ED visit. His chest pain was 8/10 at that time. Did not radiate. He mentioned pain with deep inspiration. Prior to Sunday night he describes feeling tired, malaise on Saturday. He says he had a fever on Saturday. Temperature at that time unknown. Otherwise patient was in usual state of health. Of note, Friday 5/21 was his second dose of the COVID-19 vaccine. He denies having any adverse effects after vaccine #1. Patient diagnosed with acute pericarditis at this time thought to be due to COVID-19 vaccine

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Symptoms

Chest pain, Electrocardiogram ST segment elevation, Fatigue, Malaise, Painful respiration, Pericarditis, Pyrexia, Troponin I increased, Vaccination complication

Vaccines

VAX DATE: 05-21-2021| ONSET DATE: 05-23-2021| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EW0185 IM LA
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EW0167 IM LA

RECVDATE:05-24-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:5/23/21: His EKG there reflected ST elevations, troponin I of 10.7.
V_ADMINBY:PVT
OTHER_MEDS:None
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:05-24-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:No known drug allergies
V_FUNDBY:

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