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VAERS Report 2157296

Case Report Section

Vaer Report Details

Age: 21 years old

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
2022-01-06
Date of Onset
32
Number of days (onset date – vaccination date)
32
Adverse Event Description

acute myocarditis; chest pain; febricula; headache; this is a spontaneous report received from a contactable reporter (physician) from the regulatory authority web. regulatory number: it-minisal02-842574. a 21 year-old male patient received bnt162b2 (comirnaty, solution for injection), intramuscular, administered in arm left, administration date 06jan2022 (batch/lot number: unknown) at the age of 21 years as dose 3 (booster), 0.3 ml single for covid-19 immunization. relevant medical history included: "asymptomatic covid-19", start date: 01dec2020 (unknown if ongoing); "coeliac disease" (unknown if ongoing); "smoker" (unknown if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunization; covid-19 vaccine (dose 2; manufacturer unknown), for covid-19 immunization. the following information was reported: myocarditis (hospitalization, medically significant) with onset 07feb2022, outcome "not recovered," described as "acute myocarditis"; chest pain (hospitalization, medically significant) with onset 07feb2022, outcome "not recovered," described as "chest pain"; pyrexia (hospitalization, medically significant) with onset 07feb2022, outcome "not recovered," described as "febricula"; headache (hospitalization, medically significant) with onset 07feb2022, outcome "not recovered," described as "headache." the patient was hospitalized for myocarditis, chest pain, pyrexia, headache (discharge date: 10feb2022). clinical course: heart magnetic resonance imaging was required for confirmation. the patient, who was asymptomatic was self-discharged on 10feb2022 due to family problems. the patient underwent the following laboratory tests and procedures: c-reactive protein: (07feb2022) unknown; echocardiogram: (07feb2022) unknown; (09feb2022) unknown; electrocardiogram: (07feb2022) unknown; investigation not otherwise specified (nos): (unspecified date) normal; (unspecified date) normal; (unspecified date) normal; (unspecified date) not detected; (unspecified date) 5580; investigation nos: (unspecified date) 3.6 mg/dl; investigation nos: (unspecified date) 5338 ng/l; (unspecified date) 3104 ng/l; sars-cov-2 pcr test: (07feb2022) unknown; troponin i: (07feb2022) unknown; (09feb2022) unknown; white blood cells: (07feb2022) unknown. therapeutic measures were taken as a result of myocarditis, chest pain, pyrexia, and headache, which included ibuprofen (brufen) 600 milligrams and lansoprazole (lansox). no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test date: 20220207; test name: c-reactive protein; result unstructured data: test result:unknown; test date: 20220207; test name: echocardiogram; result unstructured data: test result:unknown; test date: 20220209; test name: echocardiogram; result unstructured data: test result:unknown; test date: 20220207; test name: electrocardiogram; result unstructured data: test result:unknown; test name: investigation nos; result unstructured data: test result:normal; test name: investigation nos; result unstructured data: test result:normal; test name: investigation nos; result unstructured data: test result:normal; test name: investigation nos; result unstructured data: test result:not detected; test name: investigation nos; result unstructured data: test result:5580; test name: investigation nos; test result: 3.6 mg/dl; test name: investigation nos; result unstructured data: test result:5338 ng/l; test name: investigation nos; result unstructured data: test result:3104 ng/l; test date: 20220207; test name: sars-cov-2 pcr test; result unstructured data: test result:unknown; test date: 20220207; test name: troponin i; result unstructured data: test result:unknown; test date: 20220209; test name: troponin i; result unstructured data: test result:unknown; test date: 20220207; test name: white blood cells; result unstructured data: test result:unknown
List of symptoms
investigation headache chest pain myocarditis pyrexia electrocardiogram white blood cell count sars-cov-2 test echocardiogram c-reactive protein troponin i
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na