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This is VAERS ID 1212596

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1212596
VAERS Form:2
Age:74.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-31
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood lactic acid normal, Confusional state, Discomfort, Feeling abnormal, Intensive care, Sepsis, Unresponsive to stimuli, Troponin T increased, Endotracheal intubation, N-terminal prohormone brain natriuretic peptide 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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone Duloxetine Insulin Lactulose Nadolol Rifaximin SITagliptin Bumetanide Omeprazole Cyanocobalamin cholecalciferol
Current Illness: None
Preexisting Conditions: Cirrhosis Diabetes, Type 2
Allergies: Aspirin, Beta Blockers, Statins
Diagnostic Lab Data: SEPSIS LACTATE WITH REFLEX result 4.5 PRO B-TYPE NATRIURETIC PEPTIDE result 1984 Troponin T high-sensitivity result 93
CDC 'Split Type':

Write-up: Patient woke up at 3am not feeling good and confused. Became increasingly confused and uncomfortable. Not very responsive to caregivers. Called an ambulance at 7:30am. ER ran tests that showed Sepsis with n o underlying infection. Patient had to be intubated. Admitted to ICU in hospital. Spent 3 days there and 4 days in regular room at hospital. Then transferred to a rehabilitation clinic where she is currently.


Changed on 5/7/2021

VAERS ID: 1212596 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-31
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood lactic acid normal, Confusional state, Discomfort, Feeling abnormal, Intensive care, Sepsis, Unresponsive to stimuli, Troponin T increased, Endotracheal intubation, N-terminal prohormone brain natriuretic peptide 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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone Duloxetine Insulin Lactulose Nadolol Rifaximin SITagliptin Bumetanide Omeprazole Cyanocobalamin cholecalciferol
Current Illness: None
Preexisting Conditions: Cirrhosis Diabetes, Type 2
Allergies: Aspirin, Beta Blockers, Statins Statins
Diagnostic Lab Data: SEPSIS LACTATE WITH REFLEX result 4.5 PRO B-TYPE NATRIURETIC PEPTIDE result 1984 Troponin T high-sensitivity result 93
CDC 'Split Type':

Write-up: Patient woke up at 3am not feeling good and confused. Became increasingly confused and uncomfortable. Not very responsive to caregivers. Called an ambulance at 7:30am. ER ran tests that showed Sepsis with n o underlying infection. Patient had to be intubated. Admitted to ICU in hospital. Spent 3 days there and 4 days in regular room at hospital. Then transferred to a rehabilitation clinic where she is currently.


Changed on 5/14/2021

VAERS ID: 1212596 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-31
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood lactic acid normal, Confusional state, Discomfort, Feeling abnormal, Intensive care, Sepsis, Unresponsive to stimuli, Troponin T increased, Endotracheal intubation, N-terminal prohormone brain natriuretic peptide 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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone Duloxetine Insulin Lactulose Nadolol Rifaximin SITagliptin Bumetanide Omeprazole Cyanocobalamin cholecalciferol
Current Illness: None
Preexisting Conditions: Cirrhosis Diabetes, Type 2
Allergies: Aspirin, Beta Blockers, Statins Statins
Diagnostic Lab Data: SEPSIS LACTATE WITH REFLEX result 4.5 PRO B-TYPE NATRIURETIC PEPTIDE result 1984 Troponin T high-sensitivity result 93
CDC 'Split Type':

Write-up: Patient woke up at 3am not feeling good and confused. Became increasingly confused and uncomfortable. Not very responsive to caregivers. Called an ambulance at 7:30am. ER ran tests that showed Sepsis with n o underlying infection. Patient had to be intubated. Admitted to ICU in hospital. Spent 3 days there and 4 days in regular room at hospital. Then transferred to a rehabilitation clinic where she is currently.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212596&WAYBACKHISTORY=ON

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