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This is VAERS ID 1091285

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1091285
VAERS Form:2
Age:33.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diarrhoea, Dyspnoea, Fatigue, Palpitations, Oropharyngeal pain

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: Multiple vitamins and other are unknown
Current Illness: Tachycardia hospitalization 3/3 to 3/4/21
Preexisting Conditions: HIV, CHF, Heart problems with cardiac output of 40%, Stroke/Heart Attack 2019, Sleep Apnea, Depression, Insomnia, Stomach Ulcers, Vertigo,
Allergies: Unknown
Diagnostic Lab Data: Instructed client due to high risk medical history and previous incidents of risk mortality to seek 911 call or to go to nearest Emergency Room
CDC 'Split Type':

Write-up: Client contacted NJCRI on 3/11/21 complaining that on 3/10/21 at 10 pm he began feeling tire, achy throat and this morning 3/11/21 at 8 am began with profuse diarrhea, shortness of breath and heart palpitations. BP taken by patient at home 164/90 and pulse of 140 bpm while nurse triaged on the phone.


Changed on 5/7/2021

VAERS ID: 1091285 Before After
VAERS Form:2
Age:33.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diarrhoea, Dyspnoea, Fatigue, Palpitations, Oropharyngeal pain

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: Multiple vitamins and other are unknown
Current Illness: Tachycardia hospitalization 3/3 to 3/4/21
Preexisting Conditions: HIV, CHF, Heart problems with cardiac output of 40%, Stroke/Heart Attack 2019, Sleep Apnea, Depression, Insomnia, Stomach Ulcers, Vertigo,
Allergies: Unknown Unknown
Diagnostic Lab Data: Instructed client due to high risk medical history and previous incidents of risk mortality to seek 911 call or to go to nearest Emergency Room
CDC 'Split Type':

Write-up: Client contacted NJCRI on 3/11/21 complaining that on 3/10/21 at 10 pm he began feeling tire, achy throat and this morning 3/11/21 at 8 am began with profuse diarrhea, shortness of breath and heart palpitations. BP taken by patient at home 164/90 and pulse of 140 bpm while nurse triaged on the phone.


Changed on 5/14/2021

VAERS ID: 1091285 Before After
VAERS Form:2
Age:33.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diarrhoea, Dyspnoea, Fatigue, Palpitations, Oropharyngeal pain

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: Multiple vitamins and other are unknown
Current Illness: Tachycardia hospitalization 3/3 to 3/4/21
Preexisting Conditions: HIV, CHF, Heart problems with cardiac output of 40%, Stroke/Heart Attack 2019, Sleep Apnea, Depression, Insomnia, Stomach Ulcers, Vertigo,
Allergies: Unknown Unknown
Diagnostic Lab Data: Instructed client due to high risk medical history and previous incidents of risk mortality to seek 911 call or to go to nearest Emergency Room
CDC 'Split Type':

Write-up: Client contacted NJCRI on 3/11/21 complaining that on 3/10/21 at 10 pm he began feeling tire, achy throat and this morning 3/11/21 at 8 am began with profuse diarrhea, shortness of breath and heart palpitations. BP taken by patient at home 164/90 and pulse of 140 bpm while nurse triaged on the phone.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1091285&WAYBACKHISTORY=ON


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