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This is VAERS ID 1191417

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1191417
VAERS Form:2
Age:58.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-03
Onset:2021-04-03
Submitted:0000-00-00
Entered:2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Gallbladder disorder, Myocardial infarction

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately 15 minutes after administering the vaccine, the patient reported feeling dizzy. I checked her blood pressure and pulse and both were normal. On 4/8/21, an email from our manager of Human Resources stated that the patient was in the hospital since 4/7/21. It also stated she had a heart attacked and issues with her gallbladder.


Changed on 5/7/2021

VAERS ID: 1191417 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-03
Onset:2021-04-03
Submitted:0000-00-00
Entered:2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Gallbladder disorder, Myocardial infarction

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately 15 minutes after administering the vaccine, the patient reported feeling dizzy. I checked her blood pressure and pulse and both were normal. On 4/8/21, an email from our manager of Human Resources stated that the patient was in the hospital since 4/7/21. It also stated she had a heart attacked and issues with her gallbladder.


Changed on 5/14/2021

VAERS ID: 1191417 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-03
Onset:2021-04-03
Submitted:0000-00-00
Entered:2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Gallbladder disorder, Myocardial infarction

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately 15 minutes after administering the vaccine, the patient reported feeling dizzy. I checked her blood pressure and pulse and both were normal. On 4/8/21, an email from our manager of Human Resources stated that the patient was in the hospital since 4/7/21. It also stated she had a heart attacked and issues with her gallbladder.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1191417&WAYBACKHISTORY=ON

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