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This is VAERS ID 1826456

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 10/29/2021

VAERS ID: 1826456
VAERS Form: 2
Age: 17.0
Sex: Male
Location: Oregon
Vaccinated: 2021-10-23
Onset: 2021-10-23
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer (2 vaccines) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS - / 7+ LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Myocarditis, Troponin I increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: (blank)
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: crohns disease in remission
Allergies: none
Diagnostic Lab Data: elevated troponin I 1813 ng/L
CDC 'Split Type':

Write-up: chest pain, shortness of breath, likely myocarditis

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