VAERS ID: 1859836

AGE: 14| SEX: M|STATE: FR (Unknown)

Description

Acute pericarditis; extensive ST elevation; supraventricular and ventricular extrasystoles; supraventricular and ventricular extrasystoles; chest pain; This is a spontaneous report from a contactable pharmacist received from the regulatory authority. Regulatory authority report number is v21130328. This 14-year and 7-month-old male patient received the second dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number FJ7489, Expiration date 31Jan2022), via an unspecified route of administration, on 23Sep2021 at 10:00 (at the age of 14-year and 7-month-old) at single dose for COVID-19 immunisation. Body temperature before vaccination was not provided. Historical vaccine includes the first dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number FG0978, Expiration Date: 30Nov2021), via an unknown route, on 02Sep2021 at single dose for COVID-19 immunisation. No relevant medical history and concomitant medications were provided. The patient had no family history. On 10Oct2021 at 16:00 (17 days after the vaccination), the patient experienced acute pericarditis for which he was admitted at the hospital on the same day. The course of the event was as follows: the patient was awakened with chest pain at 04:00 AM (as reported) on 10Oct2021 and came to the hospital. There was no elevation of CK-MB or troponin I, etc., but electrocardiogram showed extensive ST elevation. Acute pericarditis was diagnosed, and the patient was admitted to the hospital. The patient had supraventricular and ventricular extrasystoles and oral acetylsalicylic acid (ASPIRIN) was administered as anti-inflammatory treatment. The symptoms and ECG improved over time, and the patient was discharged home on 19Oct2021, after it was confirmed that there was no exacerbation of arrhythmia even with an increase in activity level. The patient was recovering from the events. The reporting pharmacist classified the event 'acute pericarditis' as serious (Hospitalized from 10Oct2021 to 19Oct2021) and assessed that the event was related to BNT162B2. There was no other possible cause of the event such as any other diseases.

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Symptoms

Chest pain, Pericarditis, Ventricular extrasystoles, Supraventricular extrasystoles, Electrocardiogram ST segment elevation, Electrocardiogram, Troponin I, Blood creatine phosphokinase MB

Vaccines

VAX DATE: 09-23-2021| ONSET DATE: 10-10-2021| DAYS TO ONSET: 17
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH FJ7489

RECVDATE:11-11-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:9
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Test Date: 20211010; Test Name: CK-MB; Result Unstructured Data: Test Result:no elevation; Test Date: 20211010; Test Name: Electrocardiogram; Result Unstructured Data: Test Result:extensive ST elevation; Comments: extensive ST elevation; Test Date: 20211010; Test Name: troponin I; Result Unstructured Data: Test Result:no elevation
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:JPPFIZER INC202101462842
FORM_VERS:
TODAYS_DATE:11-10-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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