Report #2842771

Received May 27, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Male
Age: 29 yrs
State: WA
Recovered: Recovered
Vaccinated: Oct 9, 2021
Onset: Sep 18, 2022
Days to onset: 344
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	—	SC / LA

Symptoms (11)

Computerised tomogram heartDiarrhoeaEchocardiogramLaboratory testMyocarditisMyopericarditisNauseaPericarditisPleuritic painUltrasound Doppler abnormalVomiting

Symptom narrative

Myopericarditis. hospitalization and ambulance transportation to hospital. nausea and vomiting, diarrhea, and pleuritic chest pain. admited for likely pericarditis with mild myocarditis.

Current illness

none

Medical history

type one diabetes

Other medications

insulin type one novolog, lantus

Allergies

none

Lab data

9/19/2021 lab testing. echo completed 9/19. cardiac cta 9/19 VAS duplex venous lower extremity bilateral 9/19/21 findings suggestive of mesenteric adenitis.