VAERS ID: 1818897

AGE: 13| SEX: F|STATE: LA (United States)

Description

Patient presented chest pain on 8/20/2021. On 8/21/2021 she was diagnosed with myocarditis. She was then hospitalized for three days. She received I igiv infusion durning her hospital stay.

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Symptoms

Chest pain, Myocarditis, Echocardiogram, Blood test, Chest X-ray, Immunoglobulin therapy

Vaccines

VAX DATE: 08-18-2021| ONSET DATE: 08-20-2021| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH Ew0158 SYR RA
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EW0175 SYR RA

RECVDATE:10-26-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:4
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:Chest X-ray 8/21 to 8/23, blood work8/21-8/23, and echo of the heart 8/21
V_ADMINBY:PVT
OTHER_MEDS:Strattera 60mg and paroxetine 10mg
CUR_ILL:No
HISTORY:No
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-26-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:Shell fish, dust mites, and fire ants
V_FUNDBY:

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