VAERS ID: 1000418

AGE: 47| SEX: M|STATE: PR (United States)

Description

Pleuritic chest pain. Admitted due to acute pericariditis. Course complicated with new onset atrial fibrillation.

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Symptoms

Pericarditis, Pleural effusion, Atrial fibrillation, Chest X-ray normal, Chest X-ray abnormal, Pleuritic pain, Echocardiogram normal

Vaccines

VAX DATE: 12-15-2020| ONSET DATE: 01-04-2021| DAYS TO ONSET: 20
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EH9899 SC LA
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EK5730 SC LA

RECVDATE:02-04-2021
RPT_DATE:
CAGE_YR:47
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:5
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:TEE: Normal 2DEcho: Normal CXR: Left pleural effusion
V_ADMINBY:PVT
OTHER_MEDS:None
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-04-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Acetaminophen Aspirin Dextromethorphan Shellfish
V_FUNDBY:

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