National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1214980

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1214980
VAERS Form:2
Age:67.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Aura, Chest pain, Chest X-ray normal, Computerised tomogram abnormal, Dizziness, Dysgeusia, Electrocardiogram normal, Feeling abnormal, Heart rate irregular, Nausea, Pain in extremity, Paraesthesia, Parosmia, Pericarditis, Retching, Tremor, Blood test normal, Cardiac imaging procedure abnormal, Altered visual depth perception, Scan with contrast abnormal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Tetanus hives, vomiting age 32
Other Medications: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,
Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.
Preexisting Conditions: paralyzed vocal cord, hypothyroidism, hypertension
Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate
Diagnostic Lab Data: 4/12-13/21 EKGs, chest X-rays and blood tests normal, cardiac enzyme tests showed no heart attack. 4/13/21 Heart CT showed inflammation of the pericardium. The Cardiologist said it m was caused by the Covid 19 immunization. I was placed on colchicine for 2 weeks. I was given follow-up appointments with my primary care physician and the cardiologist. These are results my husband and I were told during my hospital stay but I do not yet have the documentation in hand.
CDC 'Split Type':

Write-up: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.


Changed on 5/7/2021

VAERS ID: 1214980 Before After
VAERS Form:2
Age:67.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Aura, Chest pain, Chest X-ray normal, Computerised tomogram abnormal, Dizziness, Dysgeusia, Electrocardiogram normal, Feeling abnormal, Heart rate irregular, Nausea, Pain in extremity, Paraesthesia, Parosmia, Pericarditis, Retching, Tremor, Blood test normal, Cardiac imaging procedure abnormal, Altered visual depth perception, Scan with contrast abnormal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Tetanus hives, vomiting age 32
Other Medications: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,
Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.
Preexisting Conditions: paralyzed vocal cord, hypothyroidism, hypertension
Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate Propionate
Diagnostic Lab Data: 4/12-13/21 EKGs, chest X-rays and blood tests normal, cardiac enzyme tests showed no heart attack. 4/13/21 Heart CT showed inflammation of the pericardium. The Cardiologist said it m was caused by the Covid 19 immunization. I was placed on colchicine for 2 weeks. I was given follow-up appointments with my primary care physician and the cardiologist. These are results my husband and I were told during my hospital stay but I do not yet have the documentation in hand.
CDC 'Split Type':

Write-up: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.


Changed on 5/14/2021

VAERS ID: 1214980 Before After
VAERS Form:2
Age:67.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Aura, Chest pain, Chest X-ray normal, Computerised tomogram abnormal, Dizziness, Dysgeusia, Electrocardiogram normal, Feeling abnormal, Heart rate irregular, Nausea, Pain in extremity, Paraesthesia, Parosmia, Pericarditis, Retching, Tremor, Blood test normal, Cardiac imaging procedure abnormal, Altered visual depth perception, Scan with contrast abnormal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Tetanus hives, vomiting age 32
Other Medications: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,
Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.
Preexisting Conditions: paralyzed vocal cord, hypothyroidism, hypertension
Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate Propionate
Diagnostic Lab Data: 4/12-13/21 EKGs, chest X-rays and blood tests normal, cardiac enzyme tests showed no heart attack. 4/13/21 Heart CT showed inflammation of the pericardium. The Cardiologist said it m was caused by the Covid 19 immunization. I was placed on colchicine for 2 weeks. I was given follow-up appointments with my primary care physician and the cardiologist. These are results my husband and I were told during my hospital stay but I do not yet have the documentation in hand.
CDC 'Split Type':

Write-up: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1214980&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166