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This is VAERS ID 1223714

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1223714
VAERS Form:2
Age:36.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-20
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Public      Purchased by: ??
Symptoms: Death, Malaise, Migraine

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown- This report came second hand. I know that this patient has an extensive medical history, he uses a wheelchair.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: This information is second hand, I have not been in contact with next of kin- I am reporting this because I don''t know if anyone else including a medical examiner or his PCP would know that he was recently vaccinated. I was told that this patient was feeling sick for a couple of weeks. A friend visited him within the last couple days and he had a migraine headache. When they went to check on him today they found him deceased in his chair. Further investigation would be needed.


Changed on 5/7/2021

VAERS ID: 1223714 Before After
VAERS Form:2
Age:36.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-20
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Public      Purchased by: ??
Symptoms: Death, Malaise, Migraine

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown- This report came second hand. I know that this patient has an extensive medical history, he uses a wheelchair.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: This information is second hand, I have not been in contact with next of kin- I am reporting this because I don''t know if anyone else including a medical examiner or his PCP would know that he was recently vaccinated. I was told that this patient was feeling sick for a couple of weeks. A friend visited him within the last couple days and he had a migraine headache. When they went to check on him today they found him deceased in his chair. Further investigation would be needed.


Changed on 5/14/2021

VAERS ID: 1223714 Before After
VAERS Form:2
Age:36.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-20
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Public      Purchased by: ??
Symptoms: Death, Malaise, Migraine

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown- This report came second hand. I know that this patient has an extensive medical history, he uses a wheelchair.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: This information is second hand, I have not been in contact with next of kin- I am reporting this because I don''t know if anyone else including a medical examiner or his PCP would know that he was recently vaccinated. I was told that this patient was feeling sick for a couple of weeks. A friend visited him within the last couple days and he had a migraine headache. When they went to check on him today they found him deceased in his chair. Further investigation would be needed.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1223714&WAYBACKHISTORY=ON

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