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This is VAERS ID 1085779

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1085779
VAERS Form:2
Age:55.0
Sex:Male
Location:Indiana
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Amnesia, Aphasia, Disorientation, Mental status changes, NIH stroke scale score increased

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, duloxetine, empagliflozin, glipizide, insulin glargine, lisinopril, metformin
Current Illness: No acute illnesses
Preexisting Conditions: HTN, Depression, T2DM, Hyperlipidemia, ED
Allergies: No known allergies
Diagnostic Lab Data: All from 3/9/21: NIHSS of 4, aphasia
CDC 'Split Type':

Write-up: Pt presented with AMS. History provided by father at bedside. For 2 days after vaccine pt reported not knowing what he was doing and where he was. Father brought him to ED after having breakfast together and son didn''t know how to pay or what foods he liked. Was unable to recall his father''s name. Treatment: DAPT with ASA and plavix x21 days and then transition to plavix 75mg daily, atorvastatin 80mg (stroke treatment) Outcome: TBD


Changed on 5/7/2021

VAERS ID: 1085779 Before After
VAERS Form:2
Age:55.0
Sex:Male
Location:Indiana
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Amnesia, Aphasia, Disorientation, Mental status changes, NIH stroke scale score increased

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, duloxetine, empagliflozin, glipizide, insulin glargine, lisinopril, metformin
Current Illness: No acute illnesses
Preexisting Conditions: HTN, Depression, T2DM, Hyperlipidemia, ED
Allergies: No known allergies allergies
Diagnostic Lab Data: All from 3/9/21: NIHSS of 4, aphasia
CDC 'Split Type':

Write-up: Pt presented with AMS. History provided by father at bedside. For 2 days after vaccine pt reported not knowing what he was doing and where he was. Father brought him to ED after having breakfast together and son didn''t know how to pay or what foods he liked. Was unable to recall his father''s name. Treatment: DAPT with ASA and plavix x21 days and then transition to plavix 75mg daily, atorvastatin 80mg (stroke treatment) Outcome: TBD


Changed on 5/14/2021

VAERS ID: 1085779 Before After
VAERS Form:2
Age:55.0
Sex:Male
Location:Indiana
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Amnesia, Aphasia, Disorientation, Mental status changes, NIH stroke scale score increased

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, duloxetine, empagliflozin, glipizide, insulin glargine, lisinopril, metformin
Current Illness: No acute illnesses
Preexisting Conditions: HTN, Depression, T2DM, Hyperlipidemia, ED
Allergies: No known allergies allergies
Diagnostic Lab Data: All from 3/9/21: NIHSS of 4, aphasia
CDC 'Split Type':

Write-up: Pt presented with AMS. History provided by father at bedside. For 2 days after vaccine pt reported not knowing what he was doing and where he was. Father brought him to ED after having breakfast together and son didn''t know how to pay or what foods he liked. Was unable to recall his father''s name. Treatment: DAPT with ASA and plavix x21 days and then transition to plavix 75mg daily, atorvastatin 80mg (stroke treatment) Outcome: TBD

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