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This is VAERS ID 1214234

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1214234
VAERS Form:2
Age:62.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10MG CARVEDILOL 6.25MG SIMVASTATIN 20MG ASA 81MG
Current Illness:
Preexisting Conditions: TRIPLE BYPASS 2012 (HEART DISEASE)
Allergies: NO KNOWN DRUG ALLERGIES
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT CALLED AND STATED THAT HE HAD A HEART ATTACK ON 3/14/21. (TEN DAYS AFTER THE VACCINATION) HE STATES THAT HE CALLED THE DEPARTMENT OF HEALTH AND WAS TOLD TO CONTACT THE LOCATION WHERE HE RECEIVED THE VACCINATION.


Changed on 5/7/2021

VAERS ID: 1214234 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10MG CARVEDILOL 6.25MG SIMVASTATIN 20MG ASA 81MG
Current Illness:
Preexisting Conditions: TRIPLE BYPASS 2012 (HEART DISEASE)
Allergies: NO KNOWN DRUG ALLERGIES ALLERGIES
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT CALLED AND STATED THAT HE HAD A HEART ATTACK ON 3/14/21. (TEN DAYS AFTER THE VACCINATION) HE STATES THAT HE CALLED THE DEPARTMENT OF HEALTH AND WAS TOLD TO CONTACT THE LOCATION WHERE HE RECEIVED THE VACCINATION.


Changed on 5/14/2021

VAERS ID: 1214234 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10MG CARVEDILOL 6.25MG SIMVASTATIN 20MG ASA 81MG
Current Illness:
Preexisting Conditions: TRIPLE BYPASS 2012 (HEART DISEASE)
Allergies: NO KNOWN DRUG ALLERGIES ALLERGIES
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT CALLED AND STATED THAT HE HAD A HEART ATTACK ON 3/14/21. (TEN DAYS AFTER THE VACCINATION) HE STATES THAT HE CALLED THE DEPARTMENT OF HEALTH AND WAS TOLD TO CONTACT THE LOCATION WHERE HE RECEIVED THE VACCINATION.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1214234&WAYBACKHISTORY=ON

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