VAERS ID: 1753686

AGE: 12| SEX: F|STATE: TX (United States)

Description

Patient became febrile 5 days after vaccination with second COVID Pfizer Vaccine. She was admitted to hospital with fever and myositis w/ b/l thigh pain w/ difficulty walking on 9/29/21. CK elevated on admission and down trending. She had complete resolution of symptoms on 10/1/21.

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Symptoms

Pyrexia, Gait disturbance, Blood creatine phosphokinase increased, Myositis, Urine analysis normal, Pain in extremity, Red blood cell sedimentation rate normal, White blood cell count increased, C-reactive protein increased, Epstein-Barr virus antibody positive, Epstein-Barr virus antibody negative, Drug screen negative, Mononucleosis heterophile test negative, Human chorionic gonadotropin negative, Procalcitonin, Respiratory viral panel, SARS-CoV-2 test negative

Vaccines

VAX DATE: 09-22-2021| ONSET DATE: 09-27-2021| DAYS TO ONSET: 5
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH FP8448 SYR

RECVDATE:10-01-2021
RPT_DATE:
CAGE_YR:12
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:2
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:9/29/21 WBC 15.4 9/30/21 WBC 11.9 10/1/21 WBC 10.4 9/29/21 CK 228 9/30/21 CK 145 9/29/21 CRP 2.050 9/30/21 CRP 5.960 10/01/21 CRP 4.160 9/29/21 Sed Rate 12 (normal) 9/29/21 Procalcitonin <0.05 10/01/21 Procalcitonin >0.05 Coronavirus PCR Negative Respiratory Viral Panel Negative UA negative Mononucleosis Screen Negative EBV Ab + IgG and negative IgM Urine Drug Screen Negative Blood HcG Negative
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:Cough first week of September 2021
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-01-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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