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This is VAERS ID 1219079

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1219079
VAERS Form:2
Age:25.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-07
Onset:2021-04-15
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest discomfort, Computerised tomogram, Fatigue, Myalgia, Palpitations, Pericarditis, Tachycardia, Troponin

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: see above
CDC 'Split Type':

Write-up: pt had transient fatique and myalgias on 4/8 post vaccination. adm 4/15 with chest tightness and palpitations; found to have suspected polymorphic VT/wide complex tachycardia and pericarditis. otherwise healthy young adult with no med hx. CTA neg for PE. given amiodarone. echo normal LVF. troponins normal arrhythmia resolved to be discharge today


Changed on 5/7/2021

VAERS ID: 1219079 Before After
VAERS Form:2
Age:25.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-07
Onset:2021-04-15
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest discomfort, Computerised tomogram, Fatigue, Myalgia, Palpitations, Pericarditis, Tachycardia, Troponin

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKA NKA
Diagnostic Lab Data: see above
CDC 'Split Type':

Write-up: pt had transient fatique and myalgias on 4/8 post vaccination. adm 4/15 with chest tightness and palpitations; found to have suspected polymorphic VT/wide complex tachycardia and pericarditis. otherwise healthy young adult with no med hx. CTA neg for PE. given amiodarone. echo normal LVF. troponins normal arrhythmia resolved to be discharge today


Changed on 5/14/2021

VAERS ID: 1219079 Before After
VAERS Form:2
Age:25.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-07
Onset:2021-04-15
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest discomfort, Computerised tomogram, Fatigue, Myalgia, Palpitations, Pericarditis, Tachycardia, Troponin

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKA NKA
Diagnostic Lab Data: see above
CDC 'Split Type':

Write-up: pt had transient fatique and myalgias on 4/8 post vaccination. adm 4/15 with chest tightness and palpitations; found to have suspected polymorphic VT/wide complex tachycardia and pericarditis. otherwise healthy young adult with no med hx. CTA neg for PE. given amiodarone. echo normal LVF. troponins normal arrhythmia resolved to be discharge today

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1219079&WAYBACKHISTORY=ON

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