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This is VAERS ID 1168352

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1168352
VAERS Form:2
Age:63.0
Sex:Male
Location:Colorado
Vaccinated:2021-03-26
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Public      Purchased by: ??
Symptoms: Confusional state, Diarrhoea, Flushing, Gait inability, Malaise, Muscle spasms, Nausea, Vomiting, Autopsy, Toxicologic test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-01
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: none other than eye drops
Current Illness: none
Preexisting Conditions: hypertension
Allergies: unknown
Diagnostic Lab Data: Autopsy including toxicology ( pending tax). COVID 19 test done at autopsy was negative.
CDC 'Split Type':

Write-up: Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused.


Changed on 5/7/2021

VAERS ID: 1168352 Before After
VAERS Form:2
Age:63.0
Sex:Male
Location:Colorado
Vaccinated:2021-03-26
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Public      Purchased by: ??
Symptoms: Confusional state, Diarrhoea, Flushing, Gait inability, Malaise, Muscle spasms, Nausea, Vomiting, Autopsy, Toxicologic test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-01
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: none other than eye drops
Current Illness: none
Preexisting Conditions: hypertension
Allergies: unknown unknown
Diagnostic Lab Data: Autopsy including toxicology ( pending tax). COVID 19 test done at autopsy was negative.
CDC 'Split Type':

Write-up: Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused.


Changed on 5/14/2021

VAERS ID: 1168352 Before After
VAERS Form:2
Age:63.0
Sex:Male
Location:Colorado
Vaccinated:2021-03-26
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Public      Purchased by: ??
Symptoms: Confusional state, Diarrhoea, Flushing, Gait inability, Malaise, Muscle spasms, Nausea, Vomiting, Autopsy, Toxicologic test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-01
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: none other than eye drops
Current Illness: none
Preexisting Conditions: hypertension
Allergies: unknown unknown
Diagnostic Lab Data: Autopsy including toxicology ( pending tax). COVID 19 test done at autopsy was negative.
CDC 'Split Type':

Write-up: Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1168352&WAYBACKHISTORY=ON


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