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This is VAERS ID 1142457

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1142457
VAERS Form:2
Age:58.0
Sex:Female
Location:California
Vaccinated:2021-03-28
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Atrial fibrillation, Electrocardiogram, Presyncope, Cardiac monitoring

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole atovastatin coreg prednisone tylenol colace renvela
Current Illness: congestive heart failure ovarian cancer hypertension malignant ascites
Preexisting Conditions: systemic lupus end stage renal disease on hemodialysis
Allergies: penicillin sulfa codeine
Diagnostic Lab Data: ekgs cardiac monitoring
CDC 'Split Type':

Write-up: near syncopal episode and new onset of rapid atrial fibrillation


Changed on 5/7/2021

VAERS ID: 1142457 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:California
Vaccinated:2021-03-28
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Atrial fibrillation, Electrocardiogram, Presyncope, Cardiac monitoring

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole atovastatin coreg prednisone tylenol colace renvela
Current Illness: congestive heart failure ovarian cancer hypertension malignant ascites
Preexisting Conditions: systemic lupus end stage renal disease on hemodialysis
Allergies: penicillin sulfa codeine codeine
Diagnostic Lab Data: ekgs cardiac monitoring
CDC 'Split Type':

Write-up: near syncopal episode and new onset of rapid atrial fibrillation

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1142457&WAYBACKHISTORY=ON


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