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This is VAERS ID 1226944

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1226944
VAERS Form:2
Age:56.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, Fatigue, Headache, Pain, Palpitations, Rash, Rash erythematous, Rash papular, Rash pruritic, Skin warm

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data: Consulted PCP. No tests or labs were ordered.
CDC 'Split Type':

Write-up: 4/11 Sunday afternoon fatigue and tired. 4/11 Sunday night into 4/12 Monday morning woke up with severe coughing, heart racing, and a rash. The rash was present on the right side of body, chest, arm, ribs. The rash was round bumps, raised, bright red, severe itching, and warm to touch. The rash and itching presented for 5 days. Tuesday severe headache and body aches present in addition to other symptoms. Heart racing continues still to this day 4/18.


Changed on 5/7/2021

VAERS ID: 1226944 Before After
VAERS Form:2
Age:56.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, Fatigue, Headache, Pain, Palpitations, Rash, Rash erythematous, Rash papular, Rash pruritic, Skin warm

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: None
Allergies: N/A N/A
Diagnostic Lab Data: Consulted PCP. No tests or labs were ordered.
CDC 'Split Type':

Write-up: 4/11 Sunday afternoon fatigue and tired. 4/11 Sunday night into 4/12 Monday morning woke up with severe coughing, heart racing, and a rash. The rash was present on the right side of body, chest, arm, ribs. The rash was round bumps, raised, bright red, severe itching, and warm to touch. The rash and itching presented for 5 days. Tuesday severe headache and body aches present in addition to other symptoms. Heart racing continues still to this day 4/18.


Changed on 5/14/2021

VAERS ID: 1226944 Before After
VAERS Form:2
Age:56.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, Fatigue, Headache, Pain, Palpitations, Rash, Rash erythematous, Rash papular, Rash pruritic, Skin warm

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: None
Allergies: N/A N/A
Diagnostic Lab Data: Consulted PCP. No tests or labs were ordered.
CDC 'Split Type':

Write-up: 4/11 Sunday afternoon fatigue and tired. 4/11 Sunday night into 4/12 Monday morning woke up with severe coughing, heart racing, and a rash. The rash was present on the right side of body, chest, arm, ribs. The rash was round bumps, raised, bright red, severe itching, and warm to touch. The rash and itching presented for 5 days. Tuesday severe headache and body aches present in addition to other symptoms. Heart racing continues still to this day 4/18.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1226944&WAYBACKHISTORY=ON


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