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VAERS ID: 1413859

AGE: 12| SEX: F|State: CO

Description

Seen in office 6/16/21 - Complaints of Shortness of breath, cough, nasal congestion X5 days. Received COVID #2 on 6/11/21. Got fever + chills w/in 24 hours of vaccine. Treated w/ Duoneb + prednisone, QVAR + albuterol at home. Seen in ED 6/16/21 -abnormal EKG; Murmur; Labs ordered; Albuterol + Atrovent nebs, chest xray; Home w/ Albuterol, prednisone

Symptoms

Brain natriuretic peptide normal, Nasal congestion, Chills, Pyrexia, Cough, Troponin increased, Dyspnoea, Electrocardiogram abnormal

Vaccines

VAX DATE: 10 June 2021 | ONSET DATE: 11 June 2021 | DAYS TO ONSET: 1
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • EW0196

RECVDATE:17 June 2021
CAGE_YR:12
CAGE_MO:
RPT_DATE:17 June 2021
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:Y
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:EKG-abnormal; Triponin level elevated 0.078 ng/ml + BNP ProBrain Natriuretic Peptide 32pg/mL
V_ADMINBY:OTH
OTHER_MEDS:Uses Albuterol + Qvar as needed
CUR_ILL:None
HISTORY:Asthma, Environmental Allergies, Eczema, Prematurity -33 weeks
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:1
TODAYS_DATE:
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:OTH
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