VAERS ID: 1758954

AGE: 13| SEX: M|STATE: CT (United States)

Description

Woke up at night with severe left shoulder pain, 12 days after 1st vaccination, which receded and he went to bed. No symptoms the next day. Woke up early the following morning (now 14 days after vaccination) with L shoulder pain, chest pain, nausea, pale in color, at which point he was taken to the local ED. He was treated with ibuprofen and colchicine and had symptomatic resolution in less than twelve hours. Troponin began to decrease 12 hours after admission, decreased from high of 18 ng/ml to 0.34 ng/ml at time of discharge 3 days after presentation.

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Symptoms

Arthralgia, Pallor, Nausea, Chest pain, Myocarditis, Electrocardiogram ST segment elevation, Ultrasound scan normal, Viral test, Troponin increased, Adenovirus test, Enterovirus test negative, Myocardial oedema, Magnetic resonance imaging heart

Vaccines

VAX DATE: 09-15-2021| ONSET DATE: 09-28-2021| DAYS TO ONSET: 13
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FC3184 IM UN

RECVDATE:10-04-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:9/29 troponin: 0.64->16->18 ; 9/30 troponin: 13->12 ; EKG: Diffuse ST segment elevations ; Echo: normal; Cardiac MRI showed edema consistent with myocarditis (10/1). Enterovirus PCR and Adenovirus PCR drawn 9/29 were negative. No other likely cause of myocarditis was identified prior to discharge
V_ADMINBY:PHM
OTHER_MEDS:Claritin
CUR_ILL:
HISTORY:Seasonal allergies
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:09-30-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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