VAERS ID: 1754164

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

Description

pericarditis diagnosed on 9/13/21 - treated with ibuprofen, famotidine, and colchicine with resolution of pain and normalization of labs, resolution of pain in 24 hours

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Symptoms

Pain, Pericarditis, Electrocardiogram, C-reactive protein increased, Troponin T increased, N-terminal prohormone brain natriuretic peptide increased

Vaccines

VAX DATE: 09-11-2021| ONSET DATE: 09-12-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH 30130BA IM LA

RECVDATE:10-01-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:9/13/21 EKG, troponin T=1,123 ng/L, NT-proBNP=272 pg/mL, CRP=63.6 mg/L
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:fever reported on 9/12/21
HISTORY:scoliosis
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-01-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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