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This is VAERS ID 2498126

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First Appeared on 11/4/2022

VAERS ID: 2498126
VAERS Form: 2
Age: 12.0
Sex: Male
Location: Kansas
Vaccinated: 2022-09-09
Onset: 2022-10-06
Submitted: 0000-00-00
Entered: 2022-11-03
Vaccin­ation / Manu­facturer (2 vaccines) Lot / Dose Site / Route
COVID19-2: COVID19 (COVID19 (PFIZER-BIONTECH BIVALENT)) / PFIZER/BIONTECH GH9694 / 1 - / -
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Electrocardiogram normal, White blood cell count increased, Blood test abnormal, Myocardial necrosis marker normal

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? No
Previous Vaccinations:
Other Medications: Budesonide inhaler; omega 3; multivitamin; vitamin D; probiotic
Current Illness: N/A
Preexisting Conditions: ADHD; Asthma; Autism Spectrum.
Allergies: AUGMENTIN
Diagnostic Lab Data: EKG normal; blood panel elevated white blood count, heart markers were in normal range. Chest X-ray normal.
CDC 'Split Type': vsafe

Write-up: Woke up with chest pains and BPM was over 160. Mother took him to the ER where he was tested and observed for about 4 hours. Went and saw PCP, then was referred to a Cardiologist. Seeing Cardiology doctor at the end of this month.

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