Pfizer

Vaccine was given at 3pm. At 4:30pm patient had a tight chest so he used his inhaler. At 8:30pm he went into anaphylaxis---red from head to toe, swollen hands and feet, could not move fingers or toes, lips blue and swollen. He was transported to the ER.

12 yo male presenting with bilateral lower extremity paresthesias and confusion. Admitted to the hospital. Pending discharge to rehab facility. ED Note 5/19/21 Patient is a 12-year-old male with hypogammaglobulinemia, asthma, IBS who presents with weakness in his lower extremities. 6 days ago, patient had seafood and later that night vomited once, nonbloody, nonbilious. 4 days ago, he received the first dose of the Pfizer SARS-CoV2 vaccination. That day, he also felt some burning over the anterior parts of his bilateral ankles. Over the past 3 days, he has been sleeping a lot and had a headache. He has not had a fever or other muscle aches, no subsequent N/V, abdominal pain. Last night, he reported ankle pain to his mom. Today at school, he was playing kickball when he had the sensation that his ankles were not working/gave out and he fell to the ground. He had difficulty getting up and required a wheelchair. He did not lose consciousness, denied CP, palpitations, SOB, headache, vision change during or before that episode. He was not incontinent of urine/stool and had no abnormal movements noted at the time. Since then he has noted twitching in his thighs, calves and toes. He reports weakness throughout both lower extremities and has difficulty with intentional movements at the toes/ankles/knees, weakness in hips. He reports a burning sensation over the anterior ankles/dorsum of foot b/l. Denies fevers, chills, cough, SOB, CP, palpitations, abdominal pain, N/V/C. He endorses diarrhea 3x daily which is his baseline. He has panic attacks 3x daily w palpitations/SOB that self resolve. He has been on keflex for an ingrown toe nail for the last week. MRI performed with normal brain and spine. However, on repeat exam patient has diminished sensation in the bilateral feet and diminished ability to dorsiflex or plantarflex both ankles with very limited toe range of motion. Still with preserved reflexes in the patella and Achilles. Discussed at length with neurology and the family. Differential diagnosis at this point of functional neurological disorder versus Guillaine Barré syndrome. Neurology note 5/21/21 Patient is a 12yo M with hypogammaglobinemia, IBS, and poorly controlled anxiety, presenting with 4 days of lower extremity paresthesias and 1 day of hyperacute onset of lower extremity weakness and perhaps some mild confusion. History notable for covid vaccine three days prior to presentation and anixety surrounding covid and return to school. His general examination is notable for anxious affect with difficult to localize neurologic exam. Exam shows possible bilateral lower extremity weakness of TA and hamstring>quad/IP that is very challenging to grade due to poor effort and giveway, and decreased sensation in a bilateral stocking/glove distribution to all sensory modalities. MRI w/wo contrast brain and spinal cord normal on admission. LP perfromed in ED also normal. Given negative workup and history of anxiety with recent psychosocial stressors, most likely sudden onset weakness is secondary to a functional neurologic disorder. Plan for discharge to rehab pending PT evaluation.

5 days prior to admission on 5/16/21, he received a first Pfizer COVID vaccination. The day after the vaccine, he had neck pain and stiffness. He subsequently developed fever, diarrhea, and vomiting. The day prior to admission, he developed a diffuse popular rash. He was seen in clinic on 5/20 and lab work was obtained, which was consistent with MIS-C findings (elevated troponin, elevated fibrinogen, elevated CRP, hyponatremia, relatively low absolute lymphocyte count).

Thurs 5/20 4pm 1st COVID vaccine given Friday: tingly all day; 6pm developed diffuse erethema, scc alp brigh tred Sat 5/22: redness, hives worse, facial swelling started. Seen at Danbury ED. Given all supplental anaphalsix stuff, then epi. Discharged home Sunday: 5/23: Facial swelling returns, mom gives IM Epi, returns to hospital. Found to have ST abnormalities on EKG, sent to hospital for prolonged allergic reaction and eval of possible pericarditis. 5/24: continues to have urticaria, now with new petechiae/purpuric breakouts in areas where hives were, but most prominently in bilateral ankles.

The patient received the first dose of pfizer, then waited in the pharmacy waiting room for 15 minutes. Once the patient left and went home the patient caregiver said his eyes, face and lips swelled. Though his breathing was okay. The patients caregiver thinks the patient may be allergic to PEG.

On either side of his neck, h e got a red (not quite a rash) - it was not bumpy (like eczema) but patchy red. Lymph nodes were swollen on neck underneath those red patches. Itchy - On that Sunday, when I noticed it, the Pharmacist said to take: Oral Benadryl and topical Benadryl for adverse reaction. We did that for a week and it started to go away. I outlined the rash with sharpie - t did get bigger and started spreading down his shoulders. As of today, it's cleared up - you can see a dark mark where it was but it's fading away.

My son has a swollen lymph node under his left armpit. It is sore to the touch and there is no color to the area. It is not hot. He is acting normal; no fever and has an appetite. He is doing his regular activities and does not have a fever.

PT mother states that the next day her son started with fever 24 hours after the vaccine. He had a fever for the next 8 days. At times his fever got up to 103F. His other symptoms were that his lymph nodes in his neck got very swollen and painful to touch and was very tired. He also threw up 3 times on various days. He also had a very mild sore throat before his vaccine. His pediatrician thinks it was the vaccine with in combination with his virus, was tested for strep, mono and covid, and all was negative, also lab work was performed and all was negative. He slowly started to feel better after his fever went down.

Lymph node swollen since 19May; This is a spontaneous report from a contactable consumer (Patient). A 12-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection) dose 1 via an unspecified route of administration in Arm Left on 18May2021 17:15 (Batch/Lot Number: EW0162; 12-years-old age at time of vaccination) as single dose for covid-19 immunisation. Medical history included asthma and seasonal allergies. Concomitant medications included montelukast and cetirizine hydrochloride (ZYRTEC) and Smarty Pants Vitamins. The patient previously took Tamiflu and experienced drug hypersensitivity. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 19May2021 at 07:30 PM, patient had lymph node swelling. No treatment was received for event. Prior to vaccination, the patient not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The outcome of event was not resolved.

Diffuse body rash and facial swelling within first hour after injection. Rash resolved in 24 hours, with benadryl, facial swelling took 2-3 days. Mood swings and irritability also occurred, took a week to completely subside. No respiratory symptoms at any time per mom.

Mom reported that pt woke up on Sunday feeling fatigued, achy, h/a. No fever. Those symptoms improved but then a swollen area developed under armpit/axilla about the size of a golfball, not red or warm.

Patient admitted with a diagnosis of myocarditis and encephalitis, currently still hospitalized at the time of this report. From EHR note: Patient is an otherwise healthy 12yM with recent Lyme disease (erythema migrans) transferred to hospital for hyponatremia, encephalitis, myocarditis. Initially intubated due to aspiration risk, now s/p extubation and stable on RA. Broad workup so far including consultations from neurology, cardiology, immunology, and infectious disease with unclear etiology, s/p MRI and LP with c/f covid-vaccine related myocarditis/encephalitis vs lyme carditis/meningoencephalitis vs less likely MISC vs other. Infectious testing so far negative, patient otherwise has returned to baseline behavior without any current symptoms. He is transferred to general for further workup and evaluation and close monitoring. Diagnosed with Lyme 19 days prior to admission, treated with amoxicillin; p/w headache, fever and vomiting so concern for encephalitis as above vs inflammatory process post-COVID or vaccine. Less likely meningitis given reassuring initial CSF studies. Negative COVID antibody. Resolving hyponatremia, thought to be likely SIADH. Given presentation and maternal history of albinism with immunodeficiency, broad workup sent. Also with c/f possible inflammatory response/MISC-C vs vaccine myocarditis.

Day 13 after Pfizer vaccine, patient felt a lump below clavicle on R side Saw Dr. 6/5 - per prescriber, ~ 1.5 cm lymph node subclavicle; tender, discrete, moveable No other lymph nodes of concern As of 6/8 - lymph node still same size

Patient had fever the morning after the vaccine also developed left axillary swelling on the ipsilateral side of he injection. Mildly tender, but improved by the time he was seen in the office the next day.

Rash on whole body. Red, fine raised itchy rash on face, chest, back, arms Small amount in groin and on legs Face sl swollen

pt has enlarged lymph nodes and redness at site, says there is pain coming from the red site under the arm that makes it hurt to lift arm high , no pain in shoulder or top of arm per mother

On 6/6 at 4pm, pt received 2nd dose of Pfizer COVID vaccine. He felt fine that night, but the next day (Monday) woke up with a headache, which was resolved by ibuprofen 200mg. 5 hrs later, headache returned. In total, he took 3 doses of ibuprofen 200 mg that day. On Tuesday, he went on a field trip for school, during which he walked for a total of 40 min. He also went to football practice, where he did weight training and conditioning for 1 hr. He experienced no chest trauma during practice. He tolerated exercise with no dyspnea on exertion and felt perfectly normal, but when he returned home, his mom felt that he appeared unwell and his face and eyes looked swollen. At 9 pm, headache recurred but responded to ibuprofen 200 mg. This morning (Wednesday), he woke up in the early morning complaining of difficulty breathing and orthopnea. Dyspnea was improved by propping head up on more pillows. He also had headache again and received another ibuprofen 200 mg before going to the ED. Denies fever, malaise, muscle aches, chest pain, syncope, dyspnea on exertion, palpitations, URI symptoms, sore throat, cough, diarrhea, abdominal pain, vision changes, dizziness currently or since receiving the vaccine. He still endorses orthopnea but it has been improving. No recent illnesses, sick contacts, new environmental exposures, or travel recently. Admitted to Cardiac Step down with concern for troponin leak, peak at 29. Cardiac MRI confirmation of myocarditis

2nd dose of Pfizer COVID vaccine in the am on 6/9/21. Facial edema to the lips and periorbital region starting at 1400. No evidence of anaphylaxis on arrival to the ER at 2000. Pt given Benadryl 50mg and Dexamethasone 10mg with mild improvement of edema. Pt discharged home with Benadryl and epipen.

RECEIVED THE 2ND DOSE OF COVID VACCINE ON 06/09/2021, AND BY 06/10/2021 MY SON HAD DEVELOPED A SWOLLEN LYMPHNODE IN HIS ARMPIT THE SIZE OF A GOLF BALL IN AN OVAL SHAPE.

Swollen lymph node under left arm. This remained until he got his second shot. He also had a strong response to the first shot with fever and headache. He tested positive for covid in January of 2021.

Both times after my son received his Covid-19 vaccine, we noticed that his feet swelled up a few days after and have been periodically swollen since.

Systemic: Lymph Node Swelling-Medium, Additional Details: Per MD office, pt had localized axillary lymph adenopathy

Mother of PT states this survey report is for her her son. Mother of PT states her son received the Pfizer vaccine NOT the Moderna as stated on this survey. Mother of PT states her son received the second dose Pfizer vaccine on 06-10-2021and her son experienced fever, chills, fatigue and more soreness to his left arm with also lump under his left armpit. Mother of PT states she gave her son on the night of the second vaccine, Tylenol for relief of pain. Mother of PT states her son states that as of this morning her son does not have the lump under his left armpit nor any pain. Also Mother of PT states that for her son's first dose, was on 05-20-2021 and that he experienced soreness to his left arm, tiredness, pain and a lump under his left arm pit. Mother of PT states she did not take his son to see a doctor.

On 6/7/21 patient received Pfizer #2. Two days later started to complain of moderate chest pain and SOB. Seen the next day in clinic with chest pain. Troponin found to be elevated (1.740) and CRP (4.9) with a normal EKG. After discussing with Cardiology was decided to admit patient for further work up and pain control. Admitted 6/10/21. Cardiac MRI on 6/11/21 showed peri-myocarditis. Troponin trended down over 3 days stay in hospital. Pain treated with NSAIDS, symptoms improved throughout stay. Will follow up with Cardiology in 2 weeks. No strenuous activity at this time.

Patient received the Pfizer vaccine on Sunday (06/13/21) and had mild upset stomach, headache and felt achey for approximately 24 hours post vaccine that then fully resolved. At approximately 4am on 06/16/21 he developed sharp substernal chest pain that was located centrally and a bit to the left with pain worse on inspiration and with movement. No other symptoms at that time. Went to the Emergency Department where he was transferred to Hospital as his troponin was elevated at 4.02 ng/ml. His chest pain resolved with 1 dose of Ibuprofen 400 mg.

per mom, a few hours after vaccination, patient's left calf started to be come red, a little swollen, and warm to touch. mom kept an eye on it overnight and patient was still complaining following day. patient was taken to emergency room to evaluate. they checked for clots, no signs of clotting and said it was a reaction to vaccination. mom made pcp aware of reaction and it was advised not to received 2nd dose of vaccine.

Lymph node swelling and pain in left armpit and left side. Tender to the touch. This was the side of the injection. Lasted for a week after the vaccine injection.

12 y.o. male patient with history of developmental delay, seizure disorder who presented to the emergency department today with acute encephalopathy, unresponsive with bradycardia, V-tach requiring defibrillation, and acute respiratory failure requiring intubation. The family had been traveling and vacationing with extended family members and recently returned Saturday night. No sick contacts during the trip and he recently received his second COVID-19 vaccine on June 5th. On Sunday, June 20th, he had cold symptoms with stuffy nose, sneezing and minimal oral intake. Mother gave him 10ml of a multi-symptom OTC cold medication that evening. Unsure what is in the medication or if it contains Benadryl. This morning, he had an 11am swim lesion and then came back and slept on the couch. Still minimal oral intake and was resting all day long but awake most of the time. This evening at 5:43pm per mother, he received another 10ml of the multi-symptom cold medication. He was given his Vimpat and Valproic Acid medications around 7:30pm. Around 8:20/8:25pm, he was asleep and had an emesis and was not responding In the ED, he was unresponsive and poor respiratory effort with episodes of apnea and was incontient of stool during the exam. He was brought to the resuscitation room, PIV placed x2. Placed on oxygen initially. Ativan given once for possible seizure. Epinephrine given for bradycardia. Noted V-tach on rhythm. Second Epi given, started Epinephrine infusion and Shock given 2J/kg. Cardiology at bedside. Rocuronium and Etomidate given for intubation. He was intubated on the second attempt with 6.0c ETT.

ER 6/7/2021 Chest Pain, irregular heart beat/sinus arrhythmia. Labs showed, High, ALK Phosphatase, Low Creatinine, High CRP. Discharged.

Patient is a previously healthy fully-vaccinated 12 yo presenting with fever and chest pain. He had fevers to 101-102 6/17-6/19 that were responsive to antipyretics, then the chest pain started 6/20 and has been constant 5/10 pain since. It is burning and located substernal/between the scapula. Activity/breathing doesn't worsen the pain, but it is worst at night. He also reports a mild headache today that has since resolved. He went to his PCP today and had an EKG concerning for diffuse precordial ST elevations, so he was referred to the ED with concern for myo/pericarditis. Of note, Patient received a second dose of the Pfizer COVID vaccine on 6/11. He also travels every week and has removed ticks from himself that were unattached. No known bites and no rashes. He has not had any n/v/d, no abdominal pain, no cough/congestion/rhinorrhea, no syncope, no palpitations. In the ED, he was well-appearing but tachycardic to the 120s with otherwise normal vitals. He developed fever to Tmax 38.3 that improved with Motrin. On exam he had rash concerning for erythema migrans with multiple satellite lesions. He an EKG with ST elevations in the inferolateral leads. POC US did not show any pericardial effusion. Cardiology was consulted (see consult note) and recommended troponin, which was 1.08, and CRP, which was 7.52. CXR showed clear lungs and normal cardiac contours. Hospital Course: Patient was admitted for further workup and management of his perimyocarditis. Given his erythema migrans rash and positive history of recent multiple tick exposure, we were concerned about Lyme disease (Lyme antibody pending) and sent testing for co-infection (Anaplasma, Ehrlichiosis) with smear negative for Babesia. We treated him empirically with doxycycline (given antibiotic allergies) and his rash improved. We also considered myocarditis following COVID vaccination. He had serial EKG's done which showed low-normal function, with EF=55.2%. He had serial troponins sent and they were downtrending at the time of discharge. He had chest pain that improved with PRN ibuprofen. He did not require steroids or IVIG. Cardiac MRI was completed prior to discharge and showed normal function and an area of subepicardial LV myocardial late gadolinium enhancement. consistent with myocarditis. At the time of discharge, he had no chest pain, was eating and drinking normally, and family was in agreement with plan for close Cardiology and Infectious Disease follow-up.

Headache, Fatique, Diarrhea 4-6 times per day, Neck Stiffness and Pain (swollen lymph nodes), Low Grade Fever

ED Physician documentation from 6/7/21 Fever, chest pain and palpitations. Patient states he had his second Covid vaccine yesterday. Tactile fever. Treated with Tylenol at 10:30 PM. Chest pain began yesterday during the afternoon but got more intense at 11 PM.. Left-sided, constant, sharp, 6/10, worse with movement. Patient also with palpitations of the same duration. Temperature measured was 38.6 C.

approximately 2 inch long x 1.5 inch swelling under left armpit identified 2 days after vaccine administration. no redness or pain. Complained of general pain in the arm and "deep inside" his left shoulder. Has good range of motion.

Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Additional Details: occurred about 1 hour after patient left store after receiving vaccine, mother gave benadryl, symptoms improved

12 Y 4 M old male with a history of chest pain that started two days ago on Monday. On 7/11 night, he didn't feel well felt nauseous. He was able to sleep but had chest pain the following morning that improved after he vomited. The chest pain is midsternal and feels pressure-like. It lasted a few hours. He swam on 7/12 without problems (at a swim club) for an hour. He had his second dose of COVID-19 vaccine on Saturday 7/10/21. There has not been any fevers. Elevated troponin and CRP with recent COVID-19 vaccine, suspicious for post-vaccine myocarditis. He is hemodynamically stable with normal vitals and no evidence of ventricular ectopy or depressed left ventricular function. His troponin peaked at 11.05 and trended down, but his most recent value is slightly up at 8.2 from 7.6. Recommended continuing to trend the troponins for now (if they show a downward trend then twice daily is adequate, unless he develops chest pain). At this time, IVIG is held unless he becomes unstable or the troponins trend upward .

Lump above left collarbone. Size about 1.5-2? in diameter. Size reduced the following day on 7/13/21. Maybe a swollen lymph node? Slight pain during swim practice when rotating arm.

Face Swelling to 3 times it?s size with painful rash Left Eye swelled shut and couldn?t open Slight rash on upper left arm

developed symptoms of intermittent chills, headache, jaw pain, and chest pain 2 days after receiving the shot. The next day went to an emergency room, was transferred to hospital. treated with one dose of IVIG and tylenol which led to resolution of symptoms.

Developed a cold sore on the right side of mouth 2 weeks after the first vaccine and developed another cold sore on the right side of mouth 2 weeks after the second vaccine.

He received the second dose of the vaccine on 6/4. 6/6 he developed neck pain that developed into chest pain as well. He additionally had some shortness of breath. He was seen on 6/7 by his pediatrician. An electrocardiogram was obtained which showed ST elevation in the lateral precordial leads(image below). Additionally a chest x-ray was obtained demonstrating clear lungs and no notable findings. A troponin T was obtained and measured 232 ng/L(normal range 0-22). CRP 39 mg/L(normal 0-7). His chest pain resolved within 3 days of developing. He has not noted any palpitations. He has not had any syncope. He has been doing light activities without having any issues.

Broke out in a full body rash; Red, warm to touch, itchy, it was not too raised, just slightly swollen; Red, warm to touch, itchy, it was not too raised, just slightly swollen; Red, warm to touch, itchy, it was not too raised, just slightly swollen; Red, warm to touch, itchy, it was not too raised, just slightly swollen; This is a spontaneous report from a contactable consumer reported (reporter's son). A 12-years-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in Arm Left on 08Jun2021 09:00 (Batch/Lot number was not reported) as dose 2, single (at age of 12-years-old) for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient medical history was not reported. No known allergies. Concomitant medications included ascorbic acid (VITAMIN C); vitamin d nos (VITAMIN D). Historical Vaccine included the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 18May2021 09:00 administered in left arm (at age of 12-years-old) for COVID-19 immunisation. The patient broke out in a full body rash starting 2 days after the 2nd shot on 10Jun2021. Started on top of his feet and spots on his leg and by the 3rd day, was covering most of his body up to his neck. Red, warm to touch, itchy, it was not too raised, just slightly swollen on 10Jun2021. The events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Treatment received included Used Zyrtec and Benadryl per advise of doctor. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. No Hospitalization Prolonged. Outcome of the events was recovered/resolved. Information on the lot/batch number has been requested.

First dosage: sore arm Second dosage: Headaches, chills, nauseated, lump under left arm pit, and sore arm

Swollen and very sore lymph nodes in left axilla starting the day after the injection. It has only been 2 days so I do not know how long this will last. You can feel the nodes are swollen and my son is complaining that it is very sore especially when he is lifting or using the arm.

Experienced 102 fever 24 hours post dose, 48-72 hours extremely painful and swollen left lymph node--still experiencing this, extreme fatigue.

Presented 3 days after Covid vaccination with ongoing chest pain since then. He was found to have elevated troponin and elevated ST segments consistent with pericarditis. He was also found to have be Covid positive by PCR. No medications initiated. ECHO normal.

Patient developed significant and tender left axillary lymph node swelling and left upper chest swelling

Post vaccination patient lost consciousness, had involuntary muscle movements. mother was worried same reaction patient had during anaphylactic reaction to tree nut allergy and insisted to use the epipen patient had on hands and rph administered epipen and contacted paramedics

Pt. presented > 24 hours post vaccine with an acute episode of angioedema with lip/tongue/throat swelling that required Benadryl, Prednisone, and Epinephrine x 2 shots. He was transferred from Urgent Care to ER where he continued to improve and was discharged from ER several hours later with Rx for Benadryl and Prednisone.

Bilateral lower leg mild swelling and moderate pain, pain worse to right leg Pt is taking Tylenol and ibuprofen with good pain relief Pt is raising legs while sleeping at night which helps reduce the swelling

72hrs after receiving Pfizer Covid-19 vaccine the pt started experiencing left submandibular pain and swelling. 24hrs after symptoms started the pt was seen by his PCP. The PCP exam revealed mild left mandibular swelling, tenderness upon palpation, no erythema of the buccal mucosa/gums, no warmth or erythema of the overlying skin, a small firm mass palpated near the submandibular gland. Out patient Neck ultrasound obtained that revealed enlarged lymph nodes, CBC done in office that was within normal limits. Pt dx with submandibular lymphendopathy and advised to continue otc Advil as needed for the pain.

Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Weakness-Severe, Additional Details: pt was mostly unresposive and turning white and motionless; throat closing up; no other choice but to give the epi-jr shot; after administering the shot the patient started to feel better but we decided to still call 911 to be on the safe side

Pt. has history of Lymphangioma. Pt. presented with lump on chest that became inflamed and red after 9 days of receiving Covid-19 vaccine. Pt. presented with itchiness, swelling, bruising, redness, fever, hot to touch and headache. Pt. used ice packs and Ibuprofen for treatment.

He noticed a lump around his collar bone. Doctor diagnosis it as two swollen cervical neck lymph nodes. On the left side which is the same side of the body where her received the injection.

Swollen supraclavicular lymph node above his left clavical. Noticed for the first time six days later on May 24, 2021.

Patient received vaccine on 6/4/21 at 2:30 pm. Patient woke up early (before 6 am on 6/5) and complained of headache and feeling tired. Patient had fever that reached as high as 101F at 2 pm. Patient felt chills and sweats while he had fever. Patient felt better by 9:00 pm with fever down to 99F. Fever was resolved by morning of 6/6/21. Patient also had moderate pain at injection site and swollen lymph nodes in left armpit (injection side). Patient slept during the day on 6/5 and drank extra water and fluids during the day. No other treatment was provided.

My son experienced under his left arm he had swelling of lymph nodes, on the middle of his armpit. The next day it was bigger and it was tender to touch, very painful. He also had some swollen lymph nodes on his neck, left side, near the collar bone and side of his ear. His lymph nodes got bigger on Saturday, the one on his left arm was getting smaller and the one on his neck today is going down in size as well. My son was by a nurse practitioner, and she said that my son did not have any fever, he said it was consistent with the vaccine he received. To this day his lymph nodes are still present but getting smaller in size.

3 days after the vaccine, the patient woke up at 530 in the morning with sharp chest pain that lasted about 1 hour. He was also short of breath and the pain was worse when lying down. The day after the vaccine, he had fever and emesis, but that resolved within 24 hours. He was taken to hospital where he was noted to have a troponin of 6.611, and CRP of 1.8. He was transferred to another Hospital for further care. He was treated with IV Toradol. He was seen by cardiology and infectious disease. He showed improvement with nothing more than NSAIDs, and since his MRI was normal, he was not given IVIG.

Pt started with mild cold sxs the day after the vaccine. Then 2 days after the vaccine in the evening developed chest pain - mid sternal - when going to bad. Vomited x1 and pain resolved and fell asleep. Next day also with an episode of chest pain in the pm but more severe and also with n/v; took to ER but left before evaluation done bc pain resolved. The following day 2 more episodes of chest pain less severe. 5 days later sought care for follow up- EKG and labs abnormal so sent to ER for further evaluation.

Patient received covid vaccine (Pfizer) on 5/18/21. About 2 weeks prior to admission to hospital patient began having leg weakness and unsteady gait which has progressively gotten worse. Patient is beginning IVIG treatment for Guilian Barre syndrome.

Next day, started with nausea in the M (8:00), then fever (12:00 PM), then chest pain (3:00 PM). Went to the ER to be monitored. On Sunday, said pain moved from injection site to under arm (small lump).

Morning after vaccine the patient developed fever, myalgias and then developed abdominal pain and vomiting. Presented to emergency department where he was noted to have elevated inflammatory markers, gallbladder thickening, and decreased EF in the 40s. Patient met criteria for MIS-C and was treated with IVIG and steroids. Case was reported to a federal agency.

The day after the shot, June 9th, he had pain in his armpit and a bit on his left side. Later in the day he felt a lump in his armpit (I am assuming lymph node). It hurt to touch the lump and hurt any time he moved his arm. Pain continued today, June 10th, and the lump under his arm is quite big at around 1.5 inches. It is squishy to touch. Painful to touch or move arm all day today as well. No other symptoms (no fever, chills, etc).

Patient received vaccine and stayed in pharmacy building for 15 minutes. Around that time patient's parents came back up to pharmacy to notify staff that he had broken out into a rash in the back and his hands felt swollen. I asked if he had any trouble breathing and parents stated no. We followed the Adverse Event Action Plan. We called 911. Patient's parents then stated son is starting to have some breathing issue. I came out with EpiPen and was going to administer when mom stated son's symptoms has resolved greatly and she did not want me to administer EpiPen. Shortly after EMS arrived and evaluated patient and took him to hospital for observation.

13 yo M with a history of autoimmune hepatitis who presents with 1 day of fever, headache, altered mental status, and vomiting. He received his 2nd Pfizer Covid vaccine on 6/12 and began having symptoms the next night. He began taking ibuprofen for headache and fever. His symptoms worsened through the day until he had vomiting. He was saying strange things and behaving oddly. He became very hot and agitated at home, prompting mom to bring him into an outside hospital ED. There, rectal temperature was 106F and he was noted to be combative. A CMP was obtained, which was mostly normal. CT of his head was obtained, during which he had an episode of left upper extremity shaking concerning for seizure. He was reportedly alert throughout. Patient is a 13 yo M with a history of autoimmune hepatitis who presents with 1 day of fever, headache, altered mental status, vomiting, found to have cerebral edema and elevated CRP. There is no acidosis, elevated lactate, or metabolic derangement, and utox is neg. The etiology could be related to the vaccine. Ingestions are also possible given the high fever and altered mental status - particularly serotonin syndrome. Infectious etiologies are also possible given the fever. Treatments: hypertonic saline given x1 EEG started Tox screen negative Ceftriaxone and vanc given

injection site pain, headache, daytime sleepiness, sleep excessive, sore throat, swallowing difficult (because of throat pain), difficulty talking because of pain, lethargy, nasal stuffiness, nasal drip, swollen cervical glands, cough lasted 5 days, left cheek swelling

blistering rash started 24 hrs after vaccination on hands- hands then swelled and an erythematous rash appeared on body Rash persisted for 2.5 weeks; hands swelled so much he could not use pencils

Patient was admitted from PCP for extreme tachycardia and tachypnea and developed multi organ involvement with tachycardia (HR to 140-150s), slight elevation in BNP (H of 490), Troponin (H of 0.244), mild proteinuria (50-70 proteins), respiratory distress with tachypnea (RR 50s) and hypoxia requiring escalation in O2 supplementation. Also with daily fevers until starting steroids. Laboratory findings concerning for slight hypertriglyceridemia, normal Ferritin, worsening thrombocytopenia, lymphopenia, hyponatremia, and hypoalbuminemia. CT with bibasilar atelectasis vs. consolidation, but no evidence of PE. Extensive ID and rheumatological evaluation performed and unremarkable so far. Received 2 days of Doxycycline. Was started on pulse dose steroids and began to show improvement in all markers.

Approximately 24 hours after receiving the vaccine, the child complained to his mother of severe pain and swelling to which she monitored and thought nothing of it. The very next day, June 16, 2021 her son lifted his shirt to show her the area he felt was swollen to which she saw excessive swelling on his axila, arm and breast area on the side of the injection site. She took him to see his primary physician who prescribed ibuprofen, a Medrol dose pak and an epipen. Her son is at home being monitored. He was started on the ibuprofen to some relief. She is waiting to begin the dose pak until tomorrow morning 06/16/21.

Sore arm started on same day as vaccines, mild left sided chest pain and mild shortness of breath that started the next day.

During the night that he got the vaccine my son woke up with hives and I gave him some Benadryl. I gave him his rescue inhaler in the afternoon. He has not used his inhaler for over a year. The next day he had hives were much worse and his fever was going up. The hives were worse on his left arm and his arm was red around the vaccination site. He also had swelling in his face and he was having a little trouble breathing. I gave him Benadryl and Zyrtec which helped as well as Pepcid. The breathing difficulty subsided after that. He got a different rash on his back that was different from the original hives. We continued the medications and he was still Febrile until the sixth day. The sore throat is still present after nine days but the fever and hives are gone.

On the night of the vaccine, patient developed fever (Tmax 104), chills, and myalgias. He had an outbreak of herpes on his shoulder. Continued to feel very fatigued. Three days after the vaccine, he started having chest pain and shortness of breath with exertion. He continued to be fatigued. Chest pain was intermittent. Saw pediatric cardiologist at outpatient appointment on 6/15/21 where he had a normal EKG and ECHO. High sensitivity troponin on 6/15/21 was 0.08. He had a Holter monitor placed. He was asked to do activity while wearing Holter monitor and self-limit based on symptoms. He played basketball that night and had to press the Holter button 8 times while playing when he was experiencing chest pain. When he got home from practice, he felt weak and dizzy with associated chest pain. Mom notes his nails were blue/purple, and he was "lethargic" . Symptoms improved with ibuprofen. Patient did not want to do usual activity, mom called cardiology who recommended going to ED. Patient has not had chest pain since coming home from practice on 6/15/21. He was admitted to hospital on 6/16/21. Repeat high sensitivity troponin was 0.82 on 6/16/21 and repeated on 6/17/21 was 0.41. Cardiology consulted. Cardiac MRI performed with normal results. He was dizzy on 6/17/21 when he got up to use the restroom, self-resolved. Cardiology evaluated him and cleared him for discharge with outpatient follow-up and self-limitation with activity.

feeling horrible; Since the first dose he woke up with what mother states is herpes zoster on his lips; Arm hurt; headache; Tonsils hurt; didn't feel well; This is a spontaneous report from a contactable consumer (patient's mother). A 13-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), Solution for injection, Lot number: EW0167, expiry date: Aug2021), dose 1 via an unspecified route of administration, administered in left arm on 13May2021 at 12:15, as 1st dose, single for COVID-19 immunization. The patient's medical history and other allergies compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity were none. The patient's concomitant medications were not reported. The patient had no family medical history relevant to AE. The patient received no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. No additional vaccines administered on same date of the Pfizer Suspect. On 13Jan2021 at 20:00, 8 hours after getting the shot, the patient experienced tonsils started hurting. He didn't feel well and had headaches. On 14Jan2021, he had some pretty bad symptoms on Saturday morning, he woke up with herpes zoster on his lips and his mother called to pediatrician and he was very dismissive about it and said that if the body was under stress it can come out, but he never had anything like this before. It looks like little pustules around his mouth and looks like when my mom had shingles. He did mention his arm hurt a little but went to soccer practice. Clarifies the herpes zoster didn't show up until Saturday evening/night and it was starting to go away. She took son to get Covid PCR testing on 14Jan2021 and it was negative and was told that the herpes zoster was probably a reaction to the vaccine. The patient received treatment with Abreva. The outcome of the events Since the first dose he woke up with what mother states is herpes zoster on his lips was not recovered, and the other event feeling horrible was unknown, and all other events was recovering. PSCC Communication: PC Filed Product Complaint: Yes, Description of Product Complaint: Description of complaint: Asks if this could be a bad one since he was so sick and took him to get Covid PCR testing and it was negative. Thought was weird since she and her husband both had the Pfizer Covid shot and did not have any reactions. This was son's first Covid vaccine, Lot number: EW0167, expiry.

On 6/11, he developed chest pain which began upon awakening. During his evaluation in the ER that day, he was noted to have an elevated troponin level of 7.524, slightly elevated CRP level, normal D-dimer level, and otherwise, relatively unremarkable CBC and comprehensive metabolic panel. A chest x-ray was described to be unremarkable. Echocardiogram revealed normal structure and function. He was admitted and troponins were trended until 6/15. Therapy was initiated with Ketorolac every 6 hours. Repeat troponin on 6/12 increased to 8.4, echo continued to be normal. Repeat troponin on 6/13 was 10.878. Troponin on 6/14 was 0.670 with continued normal EKG and Echo. On day of discharge, troponin had decreased to 0.110. Throughout admission, patient was monitored on telemetry and he remained in sinus rhythm without ectopy. The day prior to discharge he was switched to Naproxen BID and will continued to be monitored closely for normalization of his troponin.

Patient is currently being treated for Guillain Barre syndrome, with symptoms of bilateral feet weakness that then extended up to his thighs, leading to difficulty walking and falling with attempts to stand. He has had no loss of sensation and also states that he had sensation of a full bladder but could not urinate and did experience urinary incontinence.

3 days after receiving Pfizer mRNA COVID-19 vaccine the patient acutely developed new abdominal pain followed by chest pain. The chest pain worsened in severity to the point that he presented to an Emergency Department and was found to have an elevated troponin, resulting in hospitalizaiton.

On 06/19/2021 was noted to have decreased energy and temp was ~100, tylenol given. A few hours later after completing his morning therapies he showered and went to take a nap. At this time he was febrile to 103.6. At 1600 he had seizure-like activity with trunk and upper extremity shaking as well as eyes rolling back and drooling. Parents put him in car and transported him to an outside hospital. He did stop seizing prior to getting to that hospital. Parents reported seizure lasted approximately 15 minutes with no loss of bowel or bladder control. By time he arrived at local emergency room he was back at his neurological baseline. At the outside hospital our PICU was consulted and he was given ceftriaxone and vancomycin in meningitic dosing.

Acute-onset pressure-like 3-5/10 mid-sternal non-radiating chest pain worth with inspiration associated with palpitations and light-headedness

received his first covid-19 vaccine of Pfizer at a local pharmacy in . On 6/16/21, came to see Dr. for swelling above his collarbone that started on 6/15/2021. Dr. noted a 1.5-2cm rubbery mobile lymph node in the left supraclavicular fossa. Spoke with mom, today and lymph node is still the same size on 6/21/21. Denies any new enlarged lymph nodes or any other symptoms. Dr. monitoring for resolution.

Patient is a 13 year old male who presents to the office for pain of right axillae x 3 days, swelling of right axillae x 1 day. Pain began 24 hours after receiving first covid19 vaccination in right arm. He received pfizer vaccine. Clinical exam is notable for tenderness and swelling in right axialle, diffuse erythematous flat macular rash on right chest wall. Swelling of chest wall likely is adenitis possibly due to covid19 vaccination.

10 days after second dose, developed illness which has included cough, shortness of breath, and chest pain, followed by polyarthritis (knees, elbow) and polyarthralgias (multiple joints).

My son experienced after 2nd vaccine and on Wednesday late afternoon he started getting a rash on his hands and then his eyes started to get puffy. The next morning, his face were more swollen and rash in hands were very itchy. We gave him some Benadryl. On Friday his eye was shut closed. I took him to the urgent care and they gave him a steroid shot and prescribed steroids and Pepcid for the itchiness. They gave him a Kenalog injection, Medrol 4mg therapy pack and 5 tablets of Pepcid at the urgent care. As of today, he still has some rash to his hands but his face is not swollen.

Fever, vomiting, rash, hepatitis with direct hyperbilirubinemia, acute kidney injury (resolving) Amoxicillin for strep throat, IVIG for possible Kawasaki disease,

Patient Had lymphadenitis affecting left arm ( axillar, supraclavicular , and neck ) subsequently followed by lymphadenitis affecting right arm after ( axilla, neck and supraclavicular )second dose.

Developed large lymph node (approximately 1 inch in length) in left armpit with 3 days of receiving the vaccine. Painful at first, no longer painful. Lump has not decreased in size.

Developed dizziness and fever the morning following vaccination followed by chest pain around 48 hours after vaccination. Presented to outside urgent care where pt noted to have elevated troponin >10, prompting transfer to ED. and admission for myocarditis. Symptoms improved over next several days and chest pain was well controlled with ibuprofen and tylenol.

13 year old who received his second Pfizer COVID vaccine on July 3, 2021 (3 days ago). He describes a low grade fever on the day after the vaccine which did not initially concern him. He presented to the ER yesterday with complaints of midsternal chest pain and shortness of breath and a vague history of palpitations that started yesterday morning and continued to progress over the day. The chest pain did not vary with position and was not aggravated with respiratory effort. He had an elevated troponin and CRP and was admitted for management/observation. His chest pain has resolved since starting Ibuprofen (600 mg q 6 hours). Serial troponins peaked at 22.9, now trending downward. Notable changes on serial EKG's with resolving ST segment elevation and T wave inversion. The echocardiogram showed low normal LV function but was otherwise normal. PT presentation is consistent with the newly recognized post Covid vaccine myocarditis in adolescent males. Timing of the chest pain in relation to the vaccine, EKG and echo findings and elevated troponins all support the presumed diagnosis of myocarditis. He met the criteria for a cardiac MRI to be obtained prior to discharge- results pending.

Pt's mother called to report possible s/e from covid vaccine 1st shot Pfizer for this patient. Pt's mother stated pt has noted very slight swollen lymph node on left side collar bone area since around 5/19/2021. Denies difficulty breathing, denies swallowing difficulty other emergency sx at this time for pt. mom says that they will follow-up with PCP.

I took the first dose of the vaccine( lot numberEW0196 ) on 06/16/2021, and the second dose (lot number FA6780) on 07/07/2021, The injection site started to swell and be very painful and the lymph nodes under the armpit were very swollen and painful, I also had tiredness and a headache, and I don't really get headaches. The whole left arm was also very painful. This lasted for two and a half days.

36hr after first Covid vaccine, developed urticaria multiforme; diffuse head to toe pruritic rash with welt, wheals, hives, some swelling around hands and feet. Also with cough and headache, no fever.

Mid sternal chest pain on 7/13/21 after the 2nd dose of COVID vaccine ( 7/9/21), symptom last for 1 hr, spontaneous resolved. hx of shortness of breath at night on 7/10, completely resolved the next morning. headache and muscle aching after vaccination on 7/9/21, last for 3 days. no palpitation. he is seen in office on 7/13/21 due to hx of chest pain in the morning, no current chest pain/symptoms, normal CVS exam, normal EKG. Elevated troponin I/ESR/CRP and normal CBC Troponin I 1.92 ( 0.00-0.04) , ESR 20 ( <15), CRP 3.3 ( <0.9) he again seen in ER the same day for abnormal troponin I results, recheck EKG normal., troponin down to 1.73 he was seen in pediatric cardiology clinic on 7/14/21, troponin 0.68, normal EKG and normal echocardiogram. his symptoms self resolves without medical intervention.

Pfizer COVID-19 Vaccine EUA: Myopericarditis Patient reported receiving 2nd Pfizer COVID vaccine on 7/16/21. On 7/17/21 patient started experiencing chest pain and presented to the Medical Center on 7/19/2021. Patient was then transferred to another hospital.

His neck lymph nodes are very stiff and swollen and it hurts badly. He says he has a hard time turning his neck

Throat felt tight, hx of allergy to shellfish-has epi-pen at home. This feels similar to his prior anaphylaxis. Pt. and mom agreed to epi and EMS transport. R. thigh epi administered and care was turned over to onsite EMS. Blood sugar was 210. Pt. has type 1 diabetes and uses insulin pump.

Marked axillary lymphadenopathy on the vaccine side. Significant enough to make it unlikely we will have him get the 2nd COVID vaccine I do not take that lightly as I am a physician and vaccine advocate.

very swollen lymph node in neck, above clavicle toward the neck, left side (side of vaccination). Getting bigger every day for 4 days now. Overall soreness of shoulder (despite not having much injection site soreness the days after the shot)

Patient received 1st dose Pfizer COVID vaccine at a store/pharmacy on 5/25/21. Presented to ED with chest pain on 5/28. Diagnosed with myocarditis and admitted to the hospital. ED attending note: Patient presents with acute onset of chest discomfort in the sternal area 2 days after the first dose of Covid vaccine. Patient's not had any fevers. No respiratory symptoms. No difficulty with respirations or any pleuritic chest pain. Denies any cough. No chest wall trauma. No back pain. No palpitations or syncope. No orthostasis. No peripheral edema. On physical exam he was mildly tachycardic in the 80s to low 90s with no murmur and no gallop. No JVD. Clear lungs. No rub. Bedside ultrasound performed by HCP had bilateral lung sliding and normal gross function based on 2 views. No pericardial effusion. EKG had ST changes. Chest x-ray was obtained without any effusions or pulmonary infiltrates. Normal cardiac silhouette. Troponin sent elevated. Cardiology consulted for possible postvaccination myocarditis. Child remained stable. Resting heart rates in the 70s and low 80s. Cardiology came to see the patient. Plan to admit to cardiology service. Presumed diagnosis of myocarditis. Cardiology admitting note: Pt. is an otherwise healthy 14yM who presents with acute onset atraumatic chest pain i/s/o recent covid vaccine, found to have mildly elevated inflammatory markers and troponin with borderline ST changes on EKG most consistent with mild peri/myocarditis at this time given overall well appearance on exam without hemodynamic or respiratory compromise and grossly normal function on POCUS, though plan for formal echo in AM. EKG w/ non-specific ST-T wave changes in precordial leads, no evidence of strain or block. Admitted to the cardiology service for serial troponins, ECHO, and close monitoring. HPI per cardiology consult note: "Patient is a healthy 14 year old with a history of alopecia who presented to the ED with mild chest pain 4 days following his first Covid vaccine (Pfizer). He had no symptoms in the days immediately following vaccine, and played basketball the day following with no symptoms, but after waking up today began having dull mid sternal chest pain. It was a 4/10, worse with lying down, non pleuritic, not sharp, and not radiating pain and not associated with any other symptoms including SOB, numbness, GI pain, cough, or anything else. Has not taken any meds for the pain. Has not exercised today. Felt "warm" this AM, but didn't check temperature and felt better throughout the day. No palpitations, dizziness. Denies ever having chest pain before and no recent illnesses or sick contacts. No notable fhx of cardiac disease. In the ED, troponin mildly elevated to 0.12 ng/mL and CRP 5 with low ESR and BNP. Bedside point-of-care US reportedly showed no clear effusion with grossly normal function. HR mainly in 70s in ED and normotensive. EKG with borderline nonspecific ST elevation in V3-V6."

Acute myocarditis presenting with chest pain and elevated troponin I. Admitted toi the PICU at Hospital on 6/2/21 (previously had been in the ER on 6/1/21 at the start of chest pain).

Swollen lymph nodes (mild swelling) in left armpit; This is a spontaneous report from a contactable consumer (patient). A 14-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration in Arm Left in May2021 at 10:45 AM (Batch/Lot Number: ER8736) (at age of the 14-year-old) as 1st dose, SINGLE for covid-19 immunisation. Medical history included precocious puberty, attention deficit hyperactivity disorder, anxiety and the patient had known allergy to animal: Pet dander. The patient received methylphenidate hydrochloride (CONCERTA), guanfacine (GUANFACINE), vitamin c [ascorbic acid], melatonin within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks and prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient was not tested for COVID-19. In May2021, the patient experienced swollen lymph nodes (mild swelling) in left armpit. The patient did not receive any treatment of the event. The outcome of the event was not recovered.

Flu-like symptoms consisting of myalgias and malaise started on 6/4/21 at 1300. Overnight into 6/6 around 0230, he began having chest pain that felt like severe heart burn and shortness of breath. Tried to sleep through it but was unable and sought care. Found to have elevated troponin level and transferred to our facility pediatric ICU for higher level of care. Currently hospitalized in Pediatric ICU.

Patient developed sudden onset of chest pain which was diagnosed as myocarditis. Feeling a little bad on 6/2/2021 with some mild chest pain on that date. Took ibuprofen. Woke up suddenly on 6/3/2021 with severe chest pain. Called pediatrician and was going to wait for them to open; however, it was so severe that they took him to the Emergency Department.

Patient presented to ED on 6/8/2021 with sub-sternal chest pain 9/10 with mild radiation down his left arm which was worse with breathing nd moving. Per patient he had 2 less severe episodes of chest pain on 6/7 which were short in duration and resolved on their own. ED evaluation was significant for mildly elevated troponin at 1.88, EKG with diffuse ST elevation, elevated CRP of 1.9, mild hyperglycemia. He had a normal chest xray. Echocardiogram demonstrated normal biventricular function with no obvious pericarditis. ***

Swollen lymph node/gland in right armpit. Gland is visible from external observation and is roughly the size of a kumquat.

On the 4th - woke up weak; light headed; and a lot of discomfort - his arm really hurt. General body achiness. After a little while, he got up and was able to take some Tylenol and attend his video school day with frequent breaks. In afternoon, he started to feel worse. 102. 6 fever - we called Tele-doc appt. His throat was sore and he had some chest pain. The doctor recommended that we go to ER to have him fully evaluated. Pain and fever got better with the Tylenol. He took another couple of dose. Next morning, he had a lot better but continued to have a low fever 100.2 - on and off that day. His lymph nodes under his left arm were quite swollen and painful. The fever did not continue yesterday but the swelling has and the pain has. He was very light-headed and brain fogged on Sunday and Monday. Seems to be better today - the lymph nodes have gone down a lot but are still swollen today. He is in process of recovering.

Pain at injection site, painful/swollen lymph nodes under arm (injection arm). Complaints 2.5 days later of acute stomach pain, and swollen lymph nodes persists. Complaints of severe headaches since 6 hours after second injection and fatigue.

2 days post vaccination patient developed hives--parent treated with Benadryl, 3 days post vaccination--patient's finger began swelling, worsening symptoms over following 4 days included increased difficulty walking (started with a limp), diarrhea, extreme pain with inability to walk Patient went to ER--admitted and given IV Toradol

Patient developed fever the day following vaccine, then developed some neck stiffness, then severe chest pain two days after vaccine and was found to have myopericarditis and currently hospitalized.

According to the patient's parent, he received Pfizer dose 2 on Sunday afternoon 6/6/21 around 12-12:30pm and woke up Monday morning 6/7/21 w/ redness, hives, facial swelling, hand swelling, and then the patient became pale and fainted. No vomiting or diarrhea. He was taken by ambulance to the Emergency room where he received epinephrine x1 and Benadryl PO after which he improved.

Patient developed vomiting and fever s/p 2nd vaccine. On day 3 s/p 2nd covid19 vaccine, developed chest pain.

Day 2 chest hurt to breathe in deeply gave Tylenol subsided 2 days later. Had UTI symptoms on day 3 gave cranberry juice also subsided 2 days later symptoms were frequent urination, pain and burning during and after, hurt when laying down. Never had any type of infection in urinary tract before. All symptoms were very treatable just didn't know he would experience these. All other symptoms he went through were expected. Fever never went above 101 and he had a temp and flu symptoms for 3 days with swelling under his arm

Noticed rash 6/9, getting progressively worse. Took to urgent care 6/10. Neck swollen and bright red 6/11.

14 y/o gentleman with PMH only significant for R orchiopexy 3 years ago who presents for persistent right inguinal pain and lymphadenopathy. The patient was last seen on 6/10 for right inguinal pain with workup significant for right inguinal lymphadenopathy on US and normal scrotal ultrasound. Patient was reportedly started on antibiotics by his PCP with no improvement. He reports overall decrease in appetite and nausea, but no emesis. He has been febrile at home up to 101F.

Symptoms: 2 days post second dose of Pfizer Vaccine Chest pain, nausea, tachycardia, and myocardial inflammation with elevated troponin and inflammatory markers Treatment: Started ibuprofen 600mg Q6H and Colchicine loading dose followed by 0.6mg QD

Fever up to 102, on 6/13 and & 6/14 ; fever resolved and on 6/15 AM - chest pain and shortness of breath. Went to ED - EKG with ST elevation, Troponin > 3. Transferred to hospital

Patient developed chest tightness and pain after exercising for the first time in a while on 6/7/2021. This worsened over the next several days and he presented to the hospital with these symptoms on 6/13/2021. Lab work revealed elevated troponins, EKG showed elevated ST segment elevation and he was diagnosed with an acute perimyocarditis.

He received the second dose of his covid vaccine on 6/7, began to experience sharp chest pain with exertion on 6/11. Pain is central, to the right of the sternum, without radiation. The pain then became more dull, aching, and has been interfering with his sleep. It does seem to be worse when he is thinking about it, better when he is distracted. He went to basketball tryouts 6/15 and the pain has been more frequent since that episode of strenuous exercise. He has not taken anything for the pain. He also notes more frequent fatigue. He denies any prior covid infection. No recent illness or sick contacts. Denies cough, fever, GI upset, diarrhea. He is going to school in-person, they all wear masks.

Developed headaches the morning after receiving the vaccine (6/16) The evening after the vaccine developed substernal chest pressure and dyspnea Symptoms continued intermittently for 4 das, then presented to emergency department Had a dry cough as well, did not have any fevers, chills, or myalgias On 6/19 chest pain and shortness of breath worsened, pediatrician advised to go to ED Admitted on 6/19 Labs showed elevated CRP, elevated troponin; repeat troponin elevated so patient received chest MRI and echo, both negative (6/20) Patient received IVIG on 6/20 Currently admitted (6/20); clinically improved with improving chest pain, no shortness of breath

His troponin peaked at 7.8, and waxed and waned over his stay. On day three, it steadily decreased to 1.2. CRP was also elevated with a max at 5.3, but was <1 on discharge. He remained on telemetry throughout his stay, and had occasional pvcs but no true ectopy. Two echos and multiple EKGs were normal. His chest pain resolved by HD 2 and he felt well after that. He was started on high dose ibuprofen and pepsid, which he should remain on for a total of 7 days.

Fever and chills onset 12 hours after shot. Then chest pain radiating to axilla worsening with exertion with associated orthopnea onset 6/18, aprx two days after shot. Admitted on 6/20/21 with elevated troponin to 16, with suspected covid vaccine related myocarditis. He is getting IVIG and ketorolac. Pt is stable now without any EKG interval changes, EKG sinus tachy with left axis deviation.

2 days after vaccine, reported to have fever (unsure what temp). 3 days post vaccine, chest pain worse when lying down and dry cough. On that day, seen in ER with abnormal ECG (ST segment elevation) and elevated troponin level. Transferred and admitted to my hospital. Given ibuprofen for chest pain which improved quickly. Reassuring cardiac findings and improved troponin and ECG and discharged to home on hospital day 3. See below for labs

Patient is a 14 y.o. male with no significant PMHx who presented on 6/7 with substernal chest pain, SOB, and diaphoresis. Chest pain while he was in class and progressively worsened, was substernal and was not affected by position. Rated pain as 7/10. He also had associated diaphoresis and SOB. He reported to his school nurse who sent him to the ED. Denies palpitations, no syncope or LOC. No trauma to his chest. No palpitations. No family history of cardiac disease. Denies fever. He plays basketball, football and bassbal but reports he had not participated in any sports after he got the second dose of the vaccine. No similar history of chest pain in the past. No history of syncope. Of note, he received the second dose of the Pfizer COVID vaccine on 6/4. He had received the first dose 3 weeks earlier. In the ED he was noted to be afebrile, PR of 64, RR of 18 and BP of 117/71. His SpO2 was 98% on room air. His Troponin T was 0.04 and BNP was <50. CRP was 10.3, Ferritin, 64 and had a reassuring CBC. Chest XR with no evidence of a cardiopulmonary process. His EKG showed borderline ST elevation in lead II. Pedi ID consulted for acute myocarditis in the setting of completed Pfizer-BioNTech COVID-19 vaccine. Echo on 6/8 showed normal cardiac anatomy and normal biventricular function. Repeat EKG on 6/8 was normal. Troponin T on 6/8 increased to 0.16. His CRP today is down to 7.3. His COVID-19 nasopharyngeal PCR is negative but SARS-CoV-2 nucleocapsid antibody and SARS-CoV-2 spike protein antibody were both positive. No known history of COVID-19 infection in patient or family members. RVP is negative. CMV serology is negative but other infectious diseases work up are pending. UA without pyuria. He has received IVIG and now on steroid.

Pericarditis: severe chest pain worse with being supine, lethargy, fatigue, starting day after vaccine, peaked in pain 3 days post-vaccine, lingering chest pain for at least 2 weeks (still present over 2 weeks later) after vaccine.

Swollen Supraclavicular Lymph Node. It was roughly 5cm x 3cm. Elongated, moveable, and slightly painful. Lymph node is going down in size, although not totally back to normal size as of 6/23/2021. It is currently 2cm x 1cm.

Patient was given vaccine with no initial side effects and was asked to wait for 15 minutes before leaving facility. During that wait time patient started to develop blurred vision, and the pharmacist was alerted that the patient fell on the way to the bathroom. Patient was then guided into the immunization room when he briefly lost consciousness. While patient was seated, pharmacist assessed for anaphylaxis reaction and contacted emergency services. Blood pressure was taken and noted to be elevated, other symptoms included blurred vision and sweating. Patient denied itching, swelling, or trouble breathing. Patient did not receive epi-pen and was assessed by emergency services. Patient recovered shortly after emergency services arrived, no further services were needed

Patient started with facial flushing at about 5pm which progressed to swelling of the face and right lower eyelid and left ear, flushing of chest, patient began scratching. NO RESP symptoms, patient was happy, laughing.

Patient was diagnosed with myocarditis on 6/24/2021 after 4 days of fever, malaise, fatigue, and an episode of chest discomfort. His evaluation revealed elevated inflammatory markers, CRP and ESR, and elevated troponin levels. His EKG and echocardiogram were normal. He has been started on colchicine.

3 lymph nodes on collar bone; This is a spontaneous report from a contactable consumer (patient's mother). A 14-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0164), via an unspecified route of administration, administered in Arm Left on 26May2021 around 5pm (at the age of 14 years old) as 1st dose, single dose, dose 2 via an unspecified route of administration, administered in Arm Right on 16Jun2021 around 5:30pm as 2nd dose, single dose for COVID-19 immunization. No patient history. Patient medical history: None. Family medical history relevant to adverse event was father got sick on second dose of vaccine. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Relevant Tests: None. No additional Vaccines Administered on Same Date of the Pfizer Suspect. No other products. The reporter stated that the patient got vaccine on 26May2021. On 04Jun2021, they noticed lymph nodes on his collar bone. They went to the pediatrician because he had never been sick or anything. After the first dose, he had labs taken and they were perfect. Nothing showed inflammation and nothing was elevated at all. The sedimentation rate was fine. There was nothing. His labs were good, and the X-ray was good. The reporter and her husband did a lot of research and thought that it was the vaccine. The pediatrician did not think that it was the vaccine. There were no cases of teenagers or men getting swollen lymph nodes, only adult women. Now, they want to do surgery on him. One pediatrician wanted to do surgery and the other said to let it wait out. The reporter stated that nobody had heard of any cases of this and asked had anyone else reported lymph nodes on teenagers. The reporter stated that she just got the second shot yesterday on 16Jun2021, so she was not letting him do anything. She was making him sit down all day. The reporter stated that she contacted Pfizer yesterday after she saw the surgeon. She did not know how to contact them. So, she sent an email asking for cases. She confirmed that she did not go through a report she just sent an email. The reporter would just like to know if anyone else, any other teenage boys had this issue. She clarified that he had 3 lymph nodes on his collar bone. She remembered exactly when it was because she freaked out. It was 04Jun2021, at 9:30 at night. He came into the living room, saying he had these knots on his neck. The reporter stated that it was different then mosquito bites because they did not itch. 2 of the lymph nodes had stayed the same and one had gotten harder and was getting firm. Treatment was started on antibiotics yesterday, that the surgeon wanted him on. It was Cephalexin 500mg, twice a day. The adverse event did not require a visit to emergency room because she thought it was the vaccine so she just took him to the pediatrician, and he could not find any reports of it. The adverse event required a visit to physician office, since getting the vaccine, he had gone to the pediatrician, and then to saw the surgeon. The patient underwent lab tests and procedures which included Labs: good, red blood cell sedimentation rate: fine, x-ray: good. The clinical outcome of the event was unknown.

Patient is a previously healthy 15 year-old presenting with chest pain and elevated troponin in the setting of recently receiving his second COVID vaccine. He was in his USOH and received his second COVID vaccine 6/17. He subsequently experienced tactile fevers, headache, and malaise for two days that resolved. Then 6/21 he developed congestion and chest pain. It is in the center of his chest, not pleuritic but worsened with sneezing/coughing. Tylenol/Motrin help, but given persistence of the pain he presented to the hospital ED. Lyme titers were sent, troponin at 1814 was 2.12, then at 1646 2.49 (normal <0.06), chem was normal, CBC had wbc 11.5 with 66% neut and Hgb 12.3. EKG and CXR were reportedly normal. He received Tylenol and Ativan and was transferred for further management. In the ED, he was afebrile with normal VS. Repeat troponin was 0.25. EKG was normal. Given elevated troponin, he is being admitted for further workup and serial cardiac enzymes and EKG. Hospital Course: Patient was admitted to the cardiology floor for troponin and chest pain monitoring. His troponin levels were trended x4 and showed return to normal. Just prior to discharge, troponin level was 0.04 (normal < 0.09). His EKG was normal throughout, and at discharge showed normal sinus rhythm. He did not have any chest pain prior to leaving the hospital. On discharge, he was tolerating a normal diet. Plan for return was discussed with family for cardiac MR on 6/25. Return precautions were discussed and family expressed understanding.

fever of 102.5F the morning after covid vaccine #2 given. Also had chest pain and shortness of breath. Tylenol given which helped with symptoms. The following day, all symptoms had resolved.

Golf ball sized lump in left armpit for 6 days. Also on day 2 post vaccine a horrible cold with cough & fever of 101.5 lasted for 2 days. Has had a cough & cold for over 8 days now.

Pfizer COVID vaccine (6/23 dose 2). That evening he developed chills. . He developed body aches, decreased energy level, and decreased appetite. He woke up with extreme chest pain that radiated to the lower portion of his neck. He felt his heart racing and found it hard to take deep breaths secondary to pain. Brought to ED for further evaluation. He was afebrile, 99.4. Cardiologist on-call, was contacted and recommended transfer to another facility. In the hospital ED

Patient developed sudden onset shortness of breath and chest pain 1.5 days after his second COVID vaccine. He has had persistent shortness of breath and chest pain since then for 1 month despite ibuprofen.

Developed mildly itchy, raised red plaque around 3 - 4 cm in diameter, treated with cetirizine and topical diphenydramine and seems to be resolving over 1 week

Pt mother called and stated that pt is vomiting and has a fever of 101.9 pt mother state that pt received the second dose of COVID vaccine on 6/29/21 and now he is having these symptoms. Pt mother state that pt had these symptoms before with the first dose however they resolved on there own. Pt is now complaining of chest pain is unable to take a deep breath because it causes him pain. Patient Has not attempted treatment at home. CHIEF COMPLAINT: VOMITING (one episode of vomiting this morning) and FEVER (fever started on Wednesday) Assessment/Plan DIAGNOSIS at time of disposition: 1. Acute myocarditis, unspecified myocarditis type 2. Acute chest pain 3. COVID-19 virus not detected Patient presents with chest pain 2 days after 2nd COVID-19 vaccine. Labs were obtained and his troponin is elevated to 122 and his CRP is also elevated. I discussed case with ID, recommended admitting to Cardiology for workup for myocarditis. 14 y/o previously healthy male who presented to hospital after onset of chest pain, fever, chills, and vomiting this morning. Found to have elevated troponin and mild ST changes on EKG. Patient recently received 2nd Pfizer-BioNTech COVID vaccine on 6/29. Admitted for close monitoring and further work up of suspected myopericarditis following COVID vaccination.

Patient reports onset of chest pain three days after his second Pfizer COVID vaccine. In the following three days after his vaccine, he had headache, decreased appetite, and mild nausea. However was still taking in fluids, decreased solid food intake. He also experienced insomnia and generalized malaise. At midnight on 07/02 he began to experience 9/10 substernal chest pain that was sharp, burning in sensation and located in the middle of the chest, non-radiating, pleuritic which lasted for several hours. Patient has had no fevers, vomiting, diarrhea, congestion, sore throat or cough. Denies any SOB, dizziness, syncope, palpitations, edema, orthopnea. There has been no trauma to the chest. No recent URIs. He was seen at a hospital where he was found to have a trop of 1251 ng/L (converting to ~1.5 in our system) then one hour later up to 1500mg/L. His EKG at the hospital demonstrated lateral ST elevations. Had a normal CXR. He was given Maalox which was not helpful. He was transferred to another medical facility after 3 hours at the hospital. Upon presentation to the emergency department, his vitals were stable. He had elevated CRP to 7.69, troponin was 1.0. CBC and Chem were normal. BNP normal at 15. Bedside ultrasound showed no pericardial effusion. Cardiology was consulted and ECHO showed mild left ventricular dysfunction with EF 47%. Repeat EKG here showed ongoing ST elevations in lateral leads, though mild. His pain has since improved to a 2/10. He has not required any medication for his pain. He is COVID/flu/RSV negative. On arrival to the floor, his chest pain had completely resolved. Patient reports the pain was pleuritic, worse with exertion and improving on rest. PMH: idiopathic urticaria Allergies: NKDA Family history: none reported, no cardiac disease or sudden cardiac death Hospital Course: Patient was admitted to the cardiology floor for continued monitoring of his troponin levels and EKG. He was then treated with IVIG 2g/kg and started on methylprednisolone IV x 2 doses. He initially had some very mild chest discomfort that improved by day 2 of admission. An echocardiogram was performed which showed improvement in his EF to 54%. Given his dysfunction, he was started on Enalapril 2.5mg twice daily. He was transitioned over to PO steroids which he tolerated well. On day of discharge, his troponin levels were trending down, and EKG was WNL. Cardiac MRI was performed and showed late gadolinium enhancement in the left ventricle. He had occasional PVCs but no arrhythmias. Viral myocarditis studies were sent and all negative. By time of discharge, patient was well-appearing, vitals stable, demonstrating good PO intake. Prescriptions sent to preferred pharmacy. Follow up with cardiology in place. Discharge instructions and return precautions reviewed with patient and parent, who expressed good understanding and agreement with plan. Patient will follow up in cardiology clinic next week with a repeat MRI 3-6 months.

Approximately 1 month (on 7/5/2021)following 2nd COVID-19 vaccination, patient developed acute focal myositis of left arm--swelling occurred in left forearm (proximal) but patient reported "soreness" along L/arm and forearm. Patient had significant elevation of creatine kinase enzyme. Edema and soreness have resolved and creatinine kinase is closer to normal by 7/9/2021.

Emergency Medicine Bell's palsy, swelling Reason for Visit Reason for Visit Swelling Pt states having 2nd pfizer shot last 7/7 and facial swelling on left side with left eye watering started 7/8 AM. Pt states lips feel swollen as well. Progress Notes Emergency Medicine A 14 year old male.with a chief complaint of Swelling (Pt states having 2nd pfizer shot last 7/7 and facial swelling on left side with left eye watering started last 7/8. Pt states lips feel swollen as well. ) History of Present Illness: This is a 14-year-old male who presents with his mother complaining of weakness and numbness of the left side of his face since yesterday morning. He states that he has difficulty closing his left eye as well as sipping from a cup or through a straw. Mother states that he had his second Covid vaccine the day prior to the onset of his symptoms. Patient states that his symptoms have improved slightly since yesterday. He denies any associated headache or extremity weakness, numbness, paralysis, paresthesias, fever, chills or other complaints.

significant flare in herpes gingivostomatitis with severe pain requiring valtrex and additional supports

The day of the 7/8 vaccination the patient developed chills. On 7/9 the patient then developed a retro-orbital headache with fevers, chills, and myalgias. These symptoms persisted and on 7/10 the patient then developed chest pain, prompting presentation to the ED with subsequent admission.

woken up with swollen his left side of his face and his cheek near his jaw whole side was significantly swollen; Fever; Diagnosed him with salivary gland infection; This is a spontaneous report from a contactable consumer. This consumer (father) reported that a 14-year-old male patient received bnt162b2 (BNT162B2, Formulation: Solution for injection), via an unspecified route of administration, administered in Arm Right on 23Jun2021 16:00 (Batch/Lot Number: EN1699) as dose number unknown, single (at the age of 14-year-old) for covid-19 immunisation. Medical history included autism spectrum disorder from an unknown date and unknown if ongoing Verbatim: Autism spectrum. Concomitant medications included risperidone, guanfacine. Reporter was calling on behalf of son he was 14-years-old and so he was autism spectrum was non verbal. The patient received the vaccine at 4pm on 23Jun, the next day which in 24th in afternoon 3 pm he developed a fever which was around closed to 100 degrees Fahrenheit and then we gave him Tylenol (Further clarification was unknown) reporter thought because of the vaccine shot. On next day morning he had woken up with swollen his left side of his face and his cheek near his jaw whole side was significantly swollen. So, we immediately took him to the urgent care. Reporter stated, no laboratory test done, doctor basically put him on antibiotic Amoxicillin (Treatment) for the salivary gland infection diagnosed him with salivary gland infection they put him on Amoxicillin and swelling subsided in 3 days and fever went in 2 days and there was no further analysis needed. Therapeutic measures were taken as a result of diagnosed him with salivary gland infection, fever, woken up with swollen his left side of his face and his cheek near his jaw whole side was significantly swollen. The outcome of the event woken up with swollen his left side of his face and his cheek near his jaw whole side was significantly swollen was recovered on 28Jun2021, event fever was recovered on 26Jun2021 and diagnosed him with salivary gland infection recovered in Jun2021. No follow-up attempts are possible. No further information is expected.

typical Guillain-Barre syndrome; he could not walk; he cannot play any sport because he cant run/ no control from his waist down; he needed a catheter ,he was not able to pee or poop; he needed a catheter ,he was not able to pee or poop; This is a spontaneous report from a contactable consumer (parent). A 14-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; Batch/Lot Number: EW0179; Expiration Date: 31Aug2021; NDC number and UPC number: unknown) via intramuscular on 15May2021 (at the age of 14-years-old) in left arm (shoulder) as a DOSE 1, SINGLE for covid-19 immunization and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; Batch/Lot Number: EW0182; Expiration Date: 31Aug2021; NDC number and UPC number: unknown) via intramuscular on 05Jun2021 (at the age of 14-years-old) in left arm (shoulder) as DOSE 2, SINGLE for covid-19 immunization. Medical history included papilloma viral infection from 06May2021 to 06May2021 and bowel movement irregularity from an unknown date and unknown if ongoing. The report was not related to a study or programme. Prior vaccinations (within 4 weeks) included HPV (human papilloma virus) vaccine on 06May2021. Concomitant medication included macrogol 3350 (MIRALAX) as he had trouble going to the bathroom because he didn't had control and had trouble with bowel movement, he started when he left the hospital, so he can get back to his bowel, but he stopped using it couple of days ago as he started to go to the bathroom on his own again. The patient received both doses of Pfizer covid vaccine. He had a serious reaction to the vaccine, he couldn't go to the bathroom on his own, he had no control from his waist down, he needed a catheter as he was not able to pee or poop. He was admitted to the emergency room on 16Jun2021 and spent 3 days in the ICU because he could not walk and move, spent 3 days in out the down rated version, total 6 days in the hospital. He was diagnosed with Guillain-Barre syndrome and he was in the hospital on his birthday in Jun2021 and was doing physical therapy to walk and run again. His mother was trying to deal with the covid compensation because they had work. She and her husband were alone in the hospital. She reported that their medical bills were going to be crazy because they had to go by ambulance from one hospital to other because they were afraid of Guillain-Barre syndrome. The patient didn't have any movement in his legs all the way up to his heart. He was not able to play any sport because he can't run. The patient was discharged from the hospital and was on physical therapy (water therapy). The patient underwent lab tests and procedures which included two MRI, spinal test, and blood work with unknown results in the emergency room as they weren't sure what was going on with him. The patient was treated with IVIG and blood thinner everyday two times a day. The outcome of all the events were unknown. Information on Lot/Batch number was available. Additional information has been requested. Follow-up attempts are completed. No further information is expected.

a few hours after getting vaccine pt developed swelling and tenderness along L lateral scapula and extended under L arm. Along latissimus dorsi. I saw patient on 7/19/21 and pt was still complaining of mild swelling and tenderness. No redness or induration. No signs of infection.

Presented with bilateral facial weakness on 7/11. Prescribed 3 day course of steroids (7/14-7/16) without improvement. Presented again on 7/18 with worsening facial weakness in addition to bilateral upper and lower extremity weakness and difficulty walking. Admitted to hospital on 7/19. On the second day of his hospitalization he was no longer ambulatory. Diagnosed with likely AIDP based on CSF studies (albuminocytologic dissociation, negative infectious work-up). Treated with 3-day course of IVIG (7/21-7/23), after which he showed significant improvement in his upper/lower extremity and facial strength and ambulation. He is being discharged with ongoing outpatient physical therapy.

At the patient's second dose appointment, he reported that after the first dose his left lymph node near his armpit on his vaccination arm became swollen about 1 day after receiving the vaccine. It remained swollen for about 3 days, then resolved. He said his arm felt tight below the lymph node, as well, which also resolved.

His mom called us this morning. She informed us that he got a bump under his left arm pit couple of hours after receiving vaccine. I advised her to call his Dr. I checked with mom this evening. He is doing well. He is under obervation.

Subject is a 14yo male who received dose 1 of Pfizer Covid19 vaccine on 7/22/21 in Left arm without incident. Then on 7/23/21, subject with c/o swelling/edema and discomfort of left axilla. Applied ice pack and took ibuprofen. Swelling and discomfort still present as of the time of this report, 7/27/2021.

Concern for a possible post-vaccine MIS-C-like inflammatory reaction Symptoms at presentation included intermittent fever and hives-like rash x 5 days, conjunctivitis x 1 day, and lip erythema x 1 day.

pt found by ems crew incomapny of mother in vaccine booth after having recieved vaccine. pt appeared to have suffered a syncapo episode due to a vaso vagal response. pt mother had consented to all ems evaluation and treatment. pt was assessed on scene and pt wa then transfered to hall way for further evaluation. original vitals at vaccine booth was bp63/42 hr 46 rr 18 spo2 99 ra. pt had perspiration on forehead and pale skin and mild visual disturbances. pt improved once in hallw ay. vitals bp 87/59 hr 52 rr 18 spo2 99 RA. pt began to "feel better" PTs mother denied any allergies or pmhx. pt care was released and pt was escorted out of center by staff with mother

AFTER VACCINE WAS GIVEN ABOUT 5-10 MINUTES LATER, PATIENT WAS EXPERIENCING DIFFICULTY SWALLOWING , NUMBNESS IN MOUTH. TOLD PATIENT TO LAY DOWN, GAVE EPIPEN 0.3MG AND CALLED 911. STAYED WITH PATIENT UNTIL EMT'S ARRIVED. AFTER PATIENT WAS HELPED BY EMT, HE WAS ABLE TO WALK OUT OF THE RX. SPOKE WITH PARENT AT 330PM ON 5/25/21 WHO STATED THAT THEY TOOK HIM TO URGENT CARE WHERE HE WAS STARTED ON ZYRTEC AND GIVEN AN RX FOR AN EPIPEN. PATIENT WILL FOLLOW UP WITH ALLERGIST, AND I RECOMMENDED IF HE IS TO GET A 2ND DOSE, THAT HE HAS IT IN AN MD OFFICE. LEFT A MESSAGE WITH PATIENT'S PEDIATRICIAN ABOUT WHAT HAPPENED.

Patient began to have chest pain 12-24 hours after administration of vaccine. Chest pain worsened over 48 hours. Pain described as constant pressing sternal chest pain. He also had associated fatigue. Initial work up consistent with peri/ myocarditis. Chest pain has no longer been persistent during admission. No chest pain at rest any longer. Patient describing some ?throbbing? heart pressure with walking.

Patient developed racing heart rate ~18 hours after his vaccine at 5 am the next morning. The racing heart rate was associated with L sided jaw pain. His family gave him 81 mg aspirin x 2 but later that day his heart racing was continuing and he developed mild chest pain, prompting him to go to ED.

On 5/23 two days after vaccine he was irritable, tired, fatigued, not sleeping well. He could not complete his track meet . He had abdominal pain, felt bloated, and he felt this nausea & discomfort. He thought he might be constipated, so he took MiraLAX and then he had diarrhea all day yesterday. on 5/26 he had a temperature of 99.2, he had acute chest pain retrosternal and feeling of compression on the chest, head fullness as if he is going to explode. He had nausea, insomnia. Ibuprofen was given to him by his mother and this helped a lot But he woke up on morning of 5/27 , but the chest pain returned with increased pressure, very nauseous, agitated, unable to be comfortable. No fever,, the pain was a sharp pressure. He had no syncope or chest shortness of breath He was seen at Hospital ER where a chest x-ray was normal. Echocardiogram was done, ,noted to have EKG changes. Troponin was elevated. He had a cardiac catheterization done emergently at hospital through the right radial artery and was noted to have normal coronaries. He also had a chest x-ray done which was negative for pulmonary lesions, and his abdominal pain he says was relieved after the MiraLAX and the diarrhea. His twin sister who received the vaccine 15 minutes after him is completely asymptomatic.

5/30/21 - Patient woke up feeling chest pain that was localized to the left side of his chest, pleuritic in nature. The problems persistent despite trying medications like tums for heartburn. Pain improved at night but never fully resolved. 5/31/21: Patient continued to have chest pain and mother became worried and brought the patient to the urgent care

Mostly nonverbal pt developed temp 100-102 evening following vaccine through following day, and on day 3 had significant chest pain warranting 911 call and ED visit. Labs were significant for leukocytosis (WBC 19.8) and CXR w R hilar pneumonia. Troponin level was normal. He has improved on ABX.

had a light fever and sore arm after vaccine, started complaining of chest pain the night after vaccine , a few days later started complaining about not being able to breath and face was swollen, mom rushed to hospital and they said his oxygen level was low and he was having a asthma attack which he hasn't had since he was a baby. hospital had to give him 8 treatments of albuterol. my son is still not completely back to his normal self

Initially had headache and chills after vaccine, on day 3 after vaccine developed chest pain (midsternal and worse with inspiration), had one episode of emesis. On admission to hospital had elevated troponin, pro-BNP, Crp, normal EKG but echo consistent with Low normal left ventricular systolic function (biplane EF = 58.9 % and 3D EF = 55.37 %).

Chest pain, headache, shortness of breath. Now with convulsive movements and periods of unresponsiveness. Work up for seizures and encephalopathy in progress. Dx studies: troponin, BNP, EKG, chest CT, head CT (all negative), CRP (elevated). Currently in Pediatric ICU and work up in progress (6/7)

My 15-year-old son received dose #2 of Pfizer?s Covid-19 vaccine at 10:30am on 6/6/21. At 1:00am on 6/8/21 he was struggling to breathe due to pain in the center of his chest upon inhalation. Nothing like this has ever happened to him before. His chest pain was worse lying down and he could not lie down or sleep and wanted to stay standing on his feet. He felt pain in both forearms too. He was crying from the pain and the difficulty of breathing, and was very tired but unable to recline in order to sleep. I called the advice nurse, who checked with the doctor on call at his pediatrician?s office, and she told us to go to the ER due to concern it may be myocarditis or pericarditis.

Extremely swollen lymph nodes in the arm pit of the injected arm. Red, hot and swollen. Sore and painful. Last almost 5 days.

Previously healthy male presented with chest pain 4 days after his second COVID vaccination. He had left chest pain for a few hours yesterday which resolved, then recurred today. Pain was constant and radiated to armpit, worse with deep breaths. CRP mildly up at 8.5. Troponin elevated at 465, CK up at 520, and AST mildly up at 62. Repeat troponin 1.5 hours later was 511. Patient did have fever for one day after his second COVID vaccine, and has otherwise been afebrile.

No tender swelling of the left axilla and left chest wall started ~ 11 hours after immunization. Has increased to extend to the inferior border of the pectoralis muscle.

Patients father called the pharmacy the next day, less than 24 hours from the time of injection, and stated that the patient woke up with his face and eyes swollen. Patient will be going to his primary care physician

RECEIVED THE 2ND DOSE OF COVID VACCINE ON 06/09/2021, AND BY 06/10/2021 MY SON HAD DEVELOPED A SWOLLEN LYMPHNODE IN HIS ARMPIT THE SIZE OF A GOLF BALL IN AN OVAL SHAPE. FEVER CHILLS SWEATING

Pt had 101 fever Sunday evening. We gave him 400mg of IBU at 6pm and 500mg of Tylenol at 10pm. His fever was gone in the morning. Monday morning, lymph nodes under his arm were swollen to the size of quarters. Pt upper arm was swollen and red around the injection site the size of a softball. The redness and swelling of the lymph nodes have been slowly diminishing.

Got second dose of vaccine 6/2. Same day had chills, myalgia, fatigue and soreness at injection site. 6/3 developed substernal chest pain and dyspnea. Admitted to hospital for suspected myocarditis given elevated troponin and mildly elevated inflammatory markers 6/4. No treatments given. Symptoms resolved and troponins improved prior to discharge 6/8. He remains well today 6/14.

The patient is a 15-year-old male with no past medical history who was in his normal state of health when he received a dose to the Pfizer COVID-19 vaccine on June 10th 2021. The day following vaccine he developed fevers and chills which she treated with Tylenol. On the morning of June 12 he developed chest pain and nausea which progressively worsened throughout the day. That day he presented to an outside hospital emergency department where he was found to have elevated troponin and EKG with ST segment elevation. He was then transferred to the hospital pediatric ICU for further care. On admission to the PICU treatment was started with IV Toradol. Echocardiogram was performed and revealed mildly decreased left ventricular systolic function. His peak troponin level was 27.43. He remains hemodynamically stable and was transferred to the pediatric floor. By 6/14/2021 his chest pain had resolved and he continued to improve with NSAID therapy alone. His troponin down trended to 2.62 on day of discharge. Repeat echo on day of discharge showed improving but still mildly diminished systolic function. Repeat ECG at discharge showed persistent ST elevation. He was discharged with a prescription to continue ibuprofen 600 mg 3 times daily and follow-up with pediatric cardiology in 1 to 2 weeks.

Patient received the vaccine on 6/11/2021. On 6/12/2021 he developed pleuritic chest pain. The pain worsened and he presented to the ED on 6/14/2021. He was found to have myocarditis and quickly improved--chest pain resolved on 6/15. Treated with a 5 day course of prednisone. Improvement started before treatment with prednisone.

Received 2nd dose of Pfizer vaccine on 6/12/21. Intermittent headaches since that time. On morning of 6/14/21 developed chest pain (described as achy and in the center of the chest). Denies shortness of breath, radiation of pain, or fevers. 6/15/21-seen at Urgent Care , EKG completed and patient transferred to another hospital. From there he was transferred to one more hospital, given concern for myocarditis. Remains hospitalized as of 6/16/21

Patient is a healthy 15 year old male presenting with chest pain in the setting of recent SARS-CoV2 vaccination. He was in his usual state of health until he received the second dose of the Pfizer/BNT SARS-CoV2 vaccination on Thursday 6/10. Shortly after and into the following day, he developed fatigue, chills, and a headache, which resolved within 24 hours. However, early this morning at around 2am, he awoke with sharp central chest pain associated with some shortness of breath, radiating to his left, prompting him to present to the ED. Initially presented to Hospital ED. Vitals stable. Labs notable for troponin 0.07 and d-dimer 1.48. EKG with sinus rhythm, ST elevation in inferior leads. Given ibuprofen 600mg and contacted Cardiology, who recommended transfer to another ED for echocardiogram and further evaluation. Here in the ED, vital stable, exam non-focal. Labs notable for troponin 0.13 and CRP 3.0; CBC, chem 10, LFTs, BNP, all within normal limits. CXR normal. Echo done which showed normal function (prelim read). Seen by ID who recommended standard workup for vaccine-induced myocarditis. He was admitted to the floor in stable condition. Hospital Course: Due to rising troponin during hospital day 1 (peak 0.23), patient was treated with IVIG 2 g/kg (6/14) and methylprednisone 30 mg BID (6/14 - 6/15). On 6/15 a cardiac MRI was obtained that showed a small area of late gadolinium enhancement of the LV with normal function. Troponin was trended every 12 hours and had decreased to 0.11 on 6/15 AM. He was transitioned to oral prednisone 30 mg BID to complete a total steroid course of 5 days (6/14 - 6/18). During admission he was found to be EBV PCR positive with all other viral testing including EBV serologies pending. It is still thought this is likely due to post-vaccine inflammation and not viral myocarditis but serologies should be followed up as outpatient. By time of discharge, patient was well-appearing, vitals stable, demonstrating good PO intake. Prescriptions sent to preferred pharmacy. Follow up with cardiology. Discharge instructions and return precautions reviewed with patient and parent, who expressed good understanding and agreement with plan. Reasons for new, changed, and discontinued medications: Prednisone for myocarditis Famotidine for stomach protection while on prednisone Discharged home with follow up tests scheduled for 6/17/21.

My son developed neck soreness and and an enlarged lymph node that weekend. On Monday following the vaccination a severe headache started which lasted 4 days, even with tylenol and ibuprofen. On Tuesday, he started complaining about not remembering what he did the day before when he woke up in the morning..memory started coming back around noon. The memory issues lasted one week and began to dissipate thankfully. After a few weeks got a call to schedule his second shot. Called the pediatrician and the pediatrician told us not to administer the second vaccine due to adverse reaction to the first. We are monitoring his memory issues..he is almost a straight A student in school last year and on an Advanced Learning Plan in high school due to high IQ. We will know if this is long lasting after attending school and monitoring his grades and headaches in the fall.

With no prior injury toe on right foot became swollen and red, similar to chilblains. Showing signs of improvent as of June 16th.

Marble sized lump above clavicle; lump right above his collar bone from on the same arm that he had the vaccine; This is a spontaneous report from a contactable consumer or other non hcp via a Pfizer Sponsored Program COVAX US Support. A 15-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0178), dose 2 via an unspecified route of administration on an unspecified date (at the age of 15 year old) as 2ND DOSE, SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously took dose 1 of BNT162B2 for COVID-19 immunization and no reaction on previous exposure to vaccine. On an unspecified date, the patient experienced marble sized lump above clavicle and lump right above his collar bone from on the same arm that he had the vaccine. Seriousness of the event was provided as unspecified. NDC and UPC number was unknown. It was reported that the patient (reporter's son) has received his second vaccine of the Pfizer COVID dose on Tuesday and he has since developed a marble sized lump above his clavicle and right above his collar bone from on the same arm that he had the vaccine and reporter was wondering if that was normal and if there was anything that she should do for it. Reporter informed that she is going to call the number and take care of her son first unless Medical information department away to connect her there faster. Outcome of the events were unknown. Follow-up attempts are possible. Information about batch no/lot no has been requested.

Received second dose of Pfizer COVID 19 vaccine on 6/11/21. The night of Sunday 6/13/21, he developed back/neck aching, chest pain/pressure, and radiating pain down his left arm. Symptoms improved Monday morning with resolution of back/neck and arm pain but continued to have constant chest pain/pressure. Seen by PCP on 6/14 where labs were drawn which resulted on 6/15 and revealed elevated troponin. Patient directed to ED where EKG, labs concerning for myocarditis then transferred to hospital ED. He continues to be hospitalized on the floor at hospital (no ICU stay required) now with improving cardiac markers.

broke out into hives; throat began to swell; breathing became difficult; anaphylaxis; patient age: 15; This is a spontaneous report from a contactable consumer (patient). A 15-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0217), dose 2 via an unspecified route of administration, administered in left arm on 03Jun2021 14:30 (at 15-year-old) as 2nd dose, single dose for COVID-19 immunization. Medical history included low growth hormone production, and known allergies: many foods. Concomitant medications included somatropin (NORDITROPIN); anastrozole (ANASTRAZOLE DENK); olopatadine; levocetirizine dihydrochloride (XYZAL); diclofenac sodium, heparin sodium (ALLE). The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0173), via an unspecified route of administration, administered in left arm on 13May2021 17:30 (at 15-year-old) as 1st dose, single dose for COVID-19 immunization. On 03Jun2021 at 17:30, the patient experienced 3-4 hours after dose, broke out into hives. He took benadryl. Throat began to swell and breathing became difficult. He used epi-pen to stop anaphylaxis. The seriousness criteria of the events was reported as life threatening. The events resulted in doctor or other healthcare professional office/clinic visit. The outcome of the events hives, throat began to swell, breathing became difficult, anaphylaxis was recovering. Since the vaccination, the patient had not been tested for COVID-19.

Patient received second COVID vaccine on 6/4. Chest pain developed on 6/6. He presented to hospital where EKG showed ST segment changes and troponin was elevated. he was transferred to our facility. In our emergency department his EKG was abnormal. His troponin was elevated, along with CRP, AST, and ALT. An echocardiogram on 6/7 showed moderately depressed LV systolic function (EF = 34%). He was admitted to the pediatric cardiology service. His picture was felt to be consistent with myopericarditis. During admission, he was treated with NSAIDs and lisinopril was initiated. Repeated echo on 6/9 showed normal LV systolic function. he was discharged home on 6/9 on ibuprofen and lisinopril with plan for pediatric cardiology follow up in 4-6 weeks. Given proximity of patient's onset of symptoms to the second Pfizer vaccine, and given similar cases reported in the literature, the chief concern is whether this patient's symptoms were related to the second Pfizer COVID vaccine. Please note, I did not care for this patient, but am reporting this case on behalf of the attending physician who cared for this patient while he was hospitalized.

Patient experienced chest pain unrelated to activity and pericarditis and myocarditis approximately 48 hours post vaccination

COVID-19 Signs and Symptoms cough same; fever same (100-101); shortness of breath same (at night); headache same; sore throat same Contacts and Exposure No known exposure. Pt received 2nd COVID vaccine on Friday 6/11/21 Quality: dry cough Severity: moderate Duration: symptoms lasting 4 days Onset/Timing: date of symptoms onset: (Sunday 6/13/2021) Context: No history of asthma or pneumonia Associated Symptoms: no wheezing; no vomiting; no diarrhea; fatigue; runny nose ROS Patient reports loss of appetite, fever (101 here today), and diminished activity. He reports congestion and sore throat but reports no ear pain. He reports cough and difficulty breathing but reports no wheezing. He reports headache but reports no dizziness. He reports no nausea, no vomiting, and no diarrhea. He reports no sneezing and no runny nose. Fever with cough, mild SOB, fatigue and pharyngitis, likely viral illness. Ibuprofen 400 mg given here now. Negative COVID test here today, will send for chest x-ray, lab work CBC (H/H, RBC, indices, WBC, plt) C-reactive protein comprehensive metabolic panel lyme disease Ab w/refl to blot (IgG, IgM), troponin I, sed rate by modified westergren. EKG done, Continue to monitor for increased WOB or any worsening of symptoms. Consult with Cardiology, Echo recommended and pt. scheduled for one.

Patient presented with four days of intermittent chest pain. Pain described as midline that worsens with eating, drinking, or lying down. Seen twice at hospital, found to have leukocytosis on 6/16/2021 and elevated troponins 6/17/2021. Transferred to hospital for ongoing monitoring.

24 hours later, patient had severe abdominal pain, was found to have pancreatitis, confirmed by labs, CT scan and ultrasound scan, was admitted to Hospital. Very quick recovery, According to mother, he was given intravenous fluids, bowel rest, and nothing else.

Redness and swelling of arm; Redness and swelling of arm; Headache; Chills; This is a spontaneous report from a contactable nurse (patient's mother) reported for son. A 15-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in left upper arm on 13May2021 07:20 (Batch/Lot Number: EW0167) as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. Patient received dose 2 via an unspecified route of administration, administered in right arm on 03Jun2021 07:20 (Batch/Lot Number: ER8736) as 2nd dose, single. Medical history included patient is immunocompromised and oral steroid dependent due to asthma and adrenal insufficiency, ongoing Hypothyroidism Diagnosed about 10 years ago, ongoing Acid reflux Diagnosed since birth, ongoing Adrenal insufficiency Diagnosed about 2 years ago, Asthma Diagnosed since birth, ongoing allergies Diagnosed since birth/infancy, ongoing Pseudotumor cerebri since 2015. Concomitant medications include acetazolamide sodium (DIAMOX) taken for Pseudotumor cerebri from 2015 and ongoing, fluticasone propionate, salmeterol xinafoate (ADVAIR) taken for asthma about 8 years and ondoing, Fluticasone taken for asthma about 4 years and ongoing, Budesonide for Sinus rinse from sinus surgery care about eight years and ondoing, Hydrocortisone for adrenal insufficiency since 16May2021 and ongoing, lansoprazole (PREVACID) taken for acid reflux since 2006 and ongoing, levothyroxine sodium (SYNTHROID) taken for Autoimmune hypothyroidism hashimotos and ongoing. Patient experienced pretty big redness and swelling of arm on 14May2021, and got worse about 2 weeks later, which was odd, like a delayed response. Had headache on 13May2021 around 14:00, lunch and took two regular strength Tylenol and drank water. Classifies as medically significant since patient had to miss two days of school. Other symptoms went away after 24 hours like the chills and normal vaccine symptoms, headache. His blood pressure and all vitals were all normal. The outcome of redness and swelling of arm was recovering but still has faint bruising color, other events outcome was recovered on 14May2021. Information on the lot/batch number has been requested. Follow-up (03Jun2021): New information reported from a contactable nurse (mother) includes: removed event "15 years old patient received t vaccine", add events "headache", "chill", "redness and swelling of arm". Case upgrade to serious.

15 yo male with myocarditis following 2nd dose of pfizer COVID-19 vaccine. He reports that he received the Pfizer COVID-19 vaccine on 6/16/21. In the 1-2 days following the vaccine he experienced fatigue, body aches, and fever to Tmax 101F. Family treated this with anti-pyretics. On 6/18 he started having a pain in his left chest. He was again febrile at that time. On the day of admission his chest pain was worse and he was experiencing pain all over his body. He was noted to be tachycardic in the ED. His initial labs showed a modestly elevated BNP to 593 with a markedly elevated troponin to 1233. CRP was mildly elevated at 3.8. Electrolytes were unremarkable as were LFTs. CBC w/ diff showed an absolute lymphopenia with ALC of 1000 but was otherwise unremarkable. D-Dimer was normal. He was admitted initially to hospital medicine and then was transferred to the ICU due to concern for risk of developing a cardiac arrhythmia. An echocardiogram done showed trace mitral regurgitation but was otherwise normal with normal LV function. CXR was fairly unremarkable. Coags are normal. Repeat electrolytes showed a slight bump in his creatinine. LFTs largely unchaged and procalcitonin of 0.16. He does have a past medical history of PCR proven COVID-19 disease in December 2020.

Admitted on 6/18 with fever, pain at injection site and chest pain. Evaluated at local ED, found to have an elevated troponin to 12 and ST elevation in anterolat leads by report on EKG. An ECHO was obtained and revealed decreased EF to 47% and he was transferred to our hospital, initially monitored with telemetry, troponin levels every 6 hours and started on scheduled ibuprofen. Troponin peaked at 22.82 first hospital night on 6/18, then down-trending. Telemetry was without any ectopy. Symptoms improved and hemodynamically stable throughout his PICU course. Transferred to the pediatric floor on 6/19, continued to do well. Discharged on 6/20 with troponin of 5.92 ng/mL and EF of 55-60% on ECHO.

Developed chest pain on 6/23 x 1 day, worse lying down/breathing in, relieved by being upright. Episodic in nature. no interventions done. Seen in primary care clinic on 6/24 - ECG should findings c/w pericarditis, so referred to cardiology for evaluation. Normal ECHO without pericardial effusion, good function. Labs notable for HS troponin of 3378 pg/mL. CRP and ESR mildly eleated (17.8 and 20 respectively). BNP normal. CBC w differential all WNL for age. COVID IgG negative. Started on ibuprofen TID with close clinical follow-up planned. no associated fever/chills/URI sx/GI sx/rash.

6/24/2021 developed tactile fever, substernal chest pain, and shortness of breath 6/25/2021 increased shortness of breath, chest pain

Body/Joint ache, Red hives, very itchy arms, legs, ankles, swollen face, hands, feet. Injection site stung after shot.

Anaphylactic reaction requiring medical attention.; This is a Spontaneous case report received from Pfizer Sponsored Program, from a contactable consumer (parent). A 15-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection Batch/Lot number was not reported, Expiration Date was not reported), via an unspecified route of administration, administered in left arm on 09Jun2021 at 19:30 as dose 2, single for covid-19 immunisation at pharmacy or drug store. The patient medical history and concomitant medications were not reported. The patient historical vaccine included first dose of BNT162B2, administered in left arm for COVID-19 immunization received on 19May2021 at 19:30. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Other medications the patient received within 2 weeks of vaccination includes dentist twilight sedation. On 11Jun2021 at 12:00, the patient experienced anaphylactic reaction requiring medical attention (medically significant). Pregnazone shots, steroids shots were received as treatment for adverse event. The patient underwent lab tests and procedures which included sars-cov-1 test: negative on 13Jun2021. Therapeutic measures were taken as a result of anaphylactic reaction requiring medical attention. The adverse events resulted in Emergency room/department or urgent care. Device Date: 14Jun2021. The patient had not been diagnosed with COVID-19 prior to vaccination and had not tested positive since the vaccination. The outcome of the events was reported as not resolved. Information on the lot/batch number has been requested.

Pt is a 15 y.o. with a history of chest pain here today for evaluation. He is an ex 29 weeker with no long term consequences of prematurity. Pt has been in his usual state of health until he developed intermittent chest pain x a few weeks. Pt had a URI for which he wasn't sure if it was allergies or a cold in April 2021. He did receive Pfizer Covid-19 vaccine (First dose 5/16/21 and 2nd dose 6/6/21). Pt came to cardiology for echo for chest pain on 6/22/21. Echo showed pericardial effusion. Pt feel that he had chest pain before the vaccine, but Mom feels like it may have no started until after the first vaccine. Pt is quite active in basketball without issues. The pain lasts for a few minutes and is on his left side radiating down. He did notice that the pain worsened in certain positions, especially while lying down. There is no history of syncope, dyspnea, cyanosis, or heart palpitations. On 6/29, Pt was still having intermittent chest pain.

Day after 2nd COVDI 19 vaccine patient presented with painful supracalvicular lymphadenopathy x2. Also had mild intermittent tingling in right arm.

15 yo M with no PMH p/w 1 day of chest pain and elevated troponin and lateral ST segment elevations. On Wednesday 6/30 he had his second dose of Pfizer COVID vaccine. There after he had headache, tactile fever, fatigue and myalgias which resolved by Friday 7/2. On Friday at midnight, he awoke with 7/10 sharp substernal chest pain, non radiating. No recent trauma to the chest. He took Tylenol at home which did not relieve the pain. No recent URI sx over the last month. The last time he remembers having URI sx was 1.5 years ago. He does endorse "one or two sneezes" over the past month, which he attributes to allergies. Today 7/3, he presented to urgent care center where he got an EKG, which was concerning for ST elevations. He was given ASA which did not relieve the pain. He was sent to hospital for further work up where he had a Troponin to 1.59, CRP to 36, AST to 79, ALT to 64, Alkphos to 74, BNP to 119, ESR to 10, and WBC to 13.4. EKG showed ST elevation in I, II, precordial leads V4 V5 V6. CXR wnl. He was given IV toradol at hospital, which alleviated his CP. He was transferred to ED for further evaluation. On arrival to the ED on 7/3, he was HDS afebrile, with BP 111/69, HR of 80, and satting 100% on RA. His CP had resolved to a level of 0/10. Additional labs were obtained including repeat CBC (with WBC 10K, Hgb of 14), normal ESR of 20, normal D-dimer of less than 0.27, BMP wnl, elevated LFTs with AST 103, ALT of 61, elevated LDH to 293, normal GGT and alk phos, normal BNP to 28, elevated CRP to 3, and an extremely elevated troponin of 3.15. NP swab for COID, Influenza A/B, and RSV were negative. CXR wnl but did note findings consistent with degenerative disc disease at one level in the mid-distal thoracic spine. Hospital Course: Patient was admitted to the cardiology floor for continued monitoring of his troponin levels and EKG. He was then treated with IVIG 2g/kg and started on methylprednisolone IV x 8 doses. His chest discomfort improved by day 2 of admission. An echocardiogram was performed which did not show any cardiac dysfunction. His troponin downtrended while on IV steroids, therefore he was transitioned over to PO steroids which he tolerated well. On day of discharge, his troponin levels were continuing to trend down, and EKG was WNL. Cardiac MRI was performed and showed late gadolinium enhancement in the left ventricle. He had occasional NSVTs/PVCs; he was started on Bisoprolol 2.5mg daily to prevent arrhythmias after discharge. He was discharged home with a Holter monitor to be worn for 4 days. Viral myocarditis studies were sent and all negative. By time of discharge, patient was well-appearing, vitals stable, demonstrating good PO intake. Prescriptions sent to preferred pharmacy. Follow up with cardiology in place. Discharge instructions and return precautions reviewed with patient and parent, who expressed good understanding and agreement with plan. Patient will follow up in cardiology clinic next week with a repeat MRI 3-6 months. Of note, CXR from 7/3 with incidental findings suspicious for degenerative disc disease at one level in the mid-distal thoracic spine. This should be followed by his primary care physician as an out patient. Reasons for new, changed, and discontinued medications: - Bisoprolol 2.5mg daily (for prevention of NSVT) - Prednisone 30mg BID (myocarditis) - Famotidine 20mg daily (while on steroids) Reasons for new, changed, and discontinued equipment: NA Relevant Diagnostic Images/Studies: Cardiac MRI (7/7): ? Normal biventricular size and systolic function. ? No regional wall motion abnormalities. ? Suggestion of increased T2 signal intensity/edema. ? Positive myocardial late gadolinium enhancement without functional correlate. ? No significant valvular dysfunction. ? No coronary artery aneurysms. ? Small pericardial effusion. Echocardiogram (7/3): ? Normal valvular function. ? Normal left ventricular size and systolic function. ? Normal diastolic function indices. ? Reduced longitudinal strain with normal circumferential strain. ? Normal appearing proximal coronary arteries. ? Qualitatively normal right ventricular systolic function. ? No pericardial effusion present. ? A comprehensive anatomic survey was not performed at this time. Tests Pending Enterovirus PCR QuaL, Stool Miscellaneous Test Arup These tests will be followed after Discharge Vitals and Discharge Physical T: 36.5 °C HR: 64 (Monitored) RR: 20 BP: 131/59 SpO2: 98% HT: 168 cm WT: 76.4 kg BMI: 27.1 Discharge Physical Exam General: NAD, lying in bed, sleepy, but conversational HEENT: atraumatic, normocephalic, no icterus, no conjunctivitis; extraocular muscles intact; moist mucous membranes CV: RRR, S1/S2, no murmurs, gallops or rubs noted; dp pulses 2+; capillary refill <2 seconds. Resp: unlabored respirations; symmetric chest expansion; clear breath sounds bilaterally Abd: soft, nontender, nondistended; bowel sounds normal Ext: no clubbing, cyanosis, or edema; normal upper and lower extremities Neuro: no atrophy, normal tone; moves all extremities equally; no focal deficits Skin: no rash or erythema Diagnosis List 1. Myocarditis, 07/04/2021 2. COVID-19 mRNA vaccine adverse reaction, 07/04/2021

Patient admitted fur to chest pain and dyspnea and found to have myopericarditis after 2nd dose of COVID-19 Pzifer vaccine. Vaccine was administered at pharmacy. First dose received on 5/15/2021, second dose on 6/5/2021. Fatigue and chills started a few hours after second dose and then developed shortness of breath, nausea, emesis and 8/10 midsternal chest pain. Presented to an urgent care facility where CXR and EKG were obtained. EKG showed early repolarizations. Labs were obtained at a local ED and showed elevated troponins, initially 11k and then to 20k and peaked there. BNP was within normal limits. Subsequent EKG showed diffuse ST-segment elevations concerning for acute pericarditis. No prior infections or symptoms like this previously. He was given colchicine at outside facility prior to transfer. At hospital he was continued on ibuprofen and monitored with telemetry and had ECHO and cardiac MRI. Latter was consistent with myopericarditis. ECHO showed normal function. He received PPI while on NSAIDs. His symptoms resolved and he was discharged to home on 6/10/2021 with activity restrictions and plan to follow-up with peds cardiology. Of note, there was an error submitting the initial VAERS report for this patient during the admission, therefore, this delayed report is being submitted.

Patient presented to the ED with 10/10 chest pain. Two days prior, he'd gotten his second COVID-19 pfizer vaccine. He denied any fever, congestion, cough, vomiting, diarrhea, or other signs of infection recently; no sick contacts. On arrival to the ED, he had normal vital signs, but physical exam was notable for sternal/epigastric pain. Laboratory evaluation, including CBC, CMP, CRP, urinalysis, urine culture, high sensitivity troponins, and lipase were obtained and notable for HS troponin of 303 pg/mL with a 2 hour repeat of 291 pg/mL. CRP was 3.5 mg/dL. His EKG had diffuse ST elevations. CXR was obtained with no evidence of cardiac border or consolidation. RUQ ultrasound showed no evidence of cholecystitis or other abnormality. Patient was admitted for presumed COVID-19 vaccine-induced myopericarditis. Echocardiogram showed normal biventricular function and no pericardial infusion. He was treated with IV toradol, with resolution of chest pain. HS troponins reached the 400s, with downtrend to the 300s prior to discharge. He was discharged on PO ibuprofen with follow-up cardiac MRI and labs.

On June 2, 2021, he awoke and complained of feeling hot, tired, and not hungry. His mother had been sick with acute gastroenteritis symptoms 2 days earlier. Over the course of the day, he had a fever to 101.6 F, and began to have loose stools (twice). He received Ibuprofen 400 mg by mouth every 6 hours for the fever, and drank plenty of fluids. On June 3, 2021, he continued to have fevers to 101.5 F, loose stools (twice again), and poor oral intake of food. I canceled his scheduled 2nd Pfizer-BioNTech vaccine, and got him a NP swab test for SARS-CoV-2 through the health department. On June 4, 2021, he had no fever but now complained of a rubbing left parasternal chest pain. On physical examination, his BP was elevated (130s/90s), he had a slight tachycardia (90s), and was afebrile. On auscultation, I heard a S4 gallop and took him immediately to the local ER.

ER visit with severe abdominal pain and vomiting. Admitted to hospital due to high liver enzymes and lymph node activity. Follow up exams including extensive labs, CT, MRI and ultrasound point to autoimmune hepatitis.

15 y/o M with hx of autism presents to the ED with chest pain. Pt received 2nd dose of COVID vaccine on Monday. Pt had body aches onset Monday and L sided chest pain onset last night. Per mom, swelling on L side of chest. Pt given Tylenol. Pt denies SOB, cough, diarrhea, emesis. Pt has 38.2C fever onset this morning. No PMH. No sick contacts. NKA. Vaccines UTD. No medications taken on a daily basis. EKG Findings Time 07/14/21 08:36:00, Rate 101, Normal sinus rhythm, T wave inversion in Inferior leads. Case d/w cardiology. Normal troponin level. Unlikely myocarditis induced by COVID vaccine. Recommends mom to follow up with Pediatrician. If pain persists next week can follow up with Cardiology or have Pediatrician do 2nd troponin test done outpatient.

Woke up with acute onset of chest pain, shortness of breath. Evaluated in local ER. Tried his albuterol inhaler without improvement so was taken to a local ER. After cleared of a pulmonary embolus he was discharged with improved symptoms.

Vasovagal syncope at 7:30pm on 7/14. Patient was lightheaded immediately prior to event and woke up on the floor. HR 45, BP 94/46 immediately after event. EMS was called. Blood sugar was normal. Patient's family brought patient to ED for evaluation. Patient was back to baseline in the ED. Of note, patient also reporting right axillary swelling and pain after vaccination (that started on 7/13)

Patient developed Kawasaki disease like symptoms with fever, rash and large coronary aneurysms. He received IVIG and infliximab treatment. Aneurysms remain large 2 weeks out from treatment.

2 weeks of abdominal pain & nausea, documented weight loss of 10lb, prolonged malaise limiting his scholastic learning, all associated with having the first covid-19 (pfizer) vaccine on 6/7/21 He had fever lasting several days that began within 2 days of vaccination (but that resolved within several day ). Labwork done at that time showed modest nonspecific elevations of inflammatory markers CRP of 42, (normal < 8), ESR 50, calprotectin 285 (120 limit). SARS covid-19 antibody semiquant to spike protein RBD was 64.4 U/mL (<0.8, Labcorp). Other tests did not identify another specific etiology, and an evaluation by another physician for myocarditis was reportedly normal. As of 7/17 he feels better with a resolution of all symptoms, labwork repeated this past week (7/15) showed a resolution of those same inflammatory markers to normal levels .

Patient had flu like symptoms that developed the evening of vaccination including fever, headache, myalgias, nausea and vomiting. He had a syncopal episode on 7/18 (2 days after vaccination) and family found him on the ground. Following this episode he complained of substernal pleuritic chest pain. Initial EKG demonstrated diffuse ST changes. He became hypotensive and developed respiratory distress with evidence of pulmonary edema on CXR. He was admitted to the PICU on 35L HFNC and received an epinephrine drip for blood pressure control. Respiratory status improved.

6/26/21--;pca; 7/8/21 mild, mildly pruritic , non-painful, bilateral conjunctival injection (left more than right) without ocular discharge--attributed to seasonal allergic conjunctivitis butstill persists at present time. 7/13/21 woke up with severe (8-9/10) sub sternal and left sided chest pain/pressure sensation, whih radiated to his back with associated difficulty breathing/shortness of breath, worsening of pain with deep inspiration and sling supine, and palpitations. Bilateral calf pain and tenderness fo left foot. Symptoms persisted. To ED at Hosptial but left without being seen due to long lines then came to our ED for evaluation. Of note received 1st dose humira without apparent side effects

7/9/21 developed moderately severe throbbing headache localized to his forehead with moderately sever painful "tight" sensation in the muscles of the back of his neck and lower back. Pain persisted for ~ 3 hours ; Temp 101 Tylenol l taken but fever and pain returned after 3-4 hours. 7/10 awakened with nausea, dizzy/lightheaded , headache, vomiting. symptoms continued until 7/12/21. Viral infection suspected but nonetheless prescribed cephalexin "in case". Fever and headache continued with once daily eesis so came to ED for evaluation 7/14/21

Chest pain and palpitations, fatigue immediately post vaccine and chest pain starting 43 hours later. Admitted at 48 hours with troponin 20,000 and decreased biventricular function on echo (RVEF 37%) consistent with myocarditis. Symptomatic improvement post IVIG treatment. Hospital stay 4 days without arrhythmia or other events. Treated with IVIG alone.

Received 1st dose of Pfizer Covid Vaccine and started becoming increasingly manic within about an hour. Complained of stomach discomfort. Became increasingly anxious and manic and was only able to sleep for two hours (received at 4pm, slept from 12am to 2am). Awake and manic the day following. Complained of stomach pain. Eating normally with no other symptoms. Started complaining of being cold and chills. Applied rotating heated blankets until he feel asleep about 10pm. Woke up at 2am. Manic and anxious. Stomach started swelling more and becoming rigid. Gave him Miralax. No change in swelling. Increased stomach pain. Gave him a suppository. Immediate small bowel movement. After two more hours and no change in swelling, gave a second suppository. Immediate small bowel movement. Stomach becoming distended and complaining of increased pain. Took him to the ER. Pain amplified on the way. Admitted to PICU after EKG in ER. Quickly declined and went into respiratory failure. Right lung had no air exchange and left lung collapsed. Myocarditis, pleural effusion, kidney damage and new onset Type I diabetes. Unexplained pneumonia. No growth from fluid in lung.

The patient had COVID-19 in July 2020. In August 2020, he developed a whole body pustular rash. He was then admitted for an "asthma exacerbation" and found to have hilar lymphadenopathy. He was treated with several courses of prednisone for his asthma during the next few months. Within few days of his first dose of the COVID19 vaccine he developed fever and severe exacerbation of his rash (which thought to be acne at that time) that resulted in hospitalization on 6/7/2021. Interestingly, he received his second dose of the meningococcal vaccine (MCV4P, Menactra, lot # U6877BA) on 6/7/2021. The patient has been treated with antimicrobials (both antibiotics and antivirals, completed course) and high-dose corticosteroids (both oral and IV) and is slowly improving. He has severe skin scarring.