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VAERS Report 2157069

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-15
Date of Onset
4
Number of days (onset date – vaccination date)
4
Adverse Event Description

precordial pain; myocarditis; troponin up to 4500; this is a spontaneous report received from a contactable reporter(s) (physician) from the ra-web. regulatory number: gr-greof-202200509. a 23 year-old male patient received bnt162b2 (comirnaty), administration date 15dec2021 (lot number: unknown) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation. the following information was reported: myocarditis (life threatening) with onset 19dec2021, outcome "recovering", described as "myocarditis"; troponin increased (life threatening) with onset 19dec2021, outcome "recovering", described as "troponin up to 4500"; chest pain (medically significant), outcome "unknown", described as "precordial pain". the patient underwent the following laboratory tests and procedures: troponin: (19dec2021) 4500, notes: 4500; (unspecified date) 62.4, notes: on discharge. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test date: 20211219; test name: troponin; result unstructured data: test result:4500; comments: 4500; test name: troponin; result unstructured data: test result:62.4; comments: on discharge
List of symptoms
chest pain myocarditis troponin increased troponin
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na