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This is VAERS ID 1076762

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1076762
VAERS Form:2
Age:41.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-05
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Palpitations

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies: UNK
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was released after 15 min of monitoring. As soon as pt got in her car 9Parking lot is 3 minutes away from vaccination site) Pt developed palpitations (HR:156/min) Pt drove to the ER (3 blocks away from parking lot) Pt is currently in the ER, HR between 107-119.


Changed on 5/7/2021

VAERS ID: 1076762 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-05
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Palpitations

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies: UNK UNK
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was released after 15 min of monitoring. As soon as pt got in her car 9Parking lot is 3 minutes away from vaccination site) Pt developed palpitations (HR:156/min) Pt drove to the ER (3 blocks away from parking lot) Pt is currently in the ER, HR between 107-119.


Changed on 5/14/2021

VAERS ID: 1076762 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-05
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Palpitations

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies: UNK UNK
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was released after 15 min of monitoring. As soon as pt got in her car 9Parking lot is 3 minutes away from vaccination site) Pt developed palpitations (HR:156/min) Pt drove to the ER (3 blocks away from parking lot) Pt is currently in the ER, HR between 107-119.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1076762&WAYBACKHISTORY=ON


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