VAERS ID: 1861598

AGE: 7| SEX: M|STATE: VA (United States)

Description

About 3 hours after receiving the vaccine, he presented in cardiogenic shock with tachycardia and hypotension. He was found to have severe LV dysfunction and is currently on ECMO. I would like to stress that he did have symptoms preceding receiving the vaccine, but felt that given the clinical decompensation that it should be reported and investigated.

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Symptoms

Hypotension, Tachycardia, Pericardial effusion, Echocardiogram, Viral test negative, Mitral valve incompetence, Cardiac valve disease, Cardiogenic shock, Echocardiogram abnormal, Ejection fraction decreased, Left ventricular dysfunction, Tricuspid valve incompetence, Borrelia test negative, Aortic valve incompetence, Systolic dysfunction, Respiratory viral panel, Lung assist device therapy, SARS-CoV-2 antibody test negative

Vaccines

VAX DATE: 11-09-2021| ONSET DATE: 11-09-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FK5618 IM LA

RECVDATE:11-11-2021
RPT_DATE:
CAGE_YR:7
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:2
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Initial TTE - 11/10/21 Summary * Structurally normal heart. * Moderate tricuspid regurgitation. * Moderate mitral regurgitation. * Normal RV pressures based on TR jet velocity and septal contour. * Normal LV size and wall thickness though moderately depressed systolic function (mmode SF 26%, mmode EF 49%, 2D EF 42%, Bullet EF 42%). * Trivial pericardial effusion posteriorly, along RV free wall. Echo 11/11/21 - Summary * Patient with history of ECMO placement (November 10, 2021). Transesophageal echocardiogram to evaluate ECMO cannulae. * Globally qualitatively severely depressed biventricular systolic function. * Aortic cannula tip is in mid ascending aorta. * Trivial+ aortic insufficiency. * Moderate mitral valve regurgitation from central coaptation defect. * Venous cannula tip in the RA and IVC junction. 11/10/21 - SARS-CoV-2 antibodies negative; Respiratory panel negative; Lyme screen negative
V_ADMINBY:PVT
OTHER_MEDS:Tylenol, motrin, zyrtec, zofran, miralax
CUR_ILL:Yes, abdominal pain preceded the vaccination on 11/5 and diarrhea on 11/7. He had increased fatigue/lethargy prior to receiving the vaccine.
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-11-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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