National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1227834

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1227834
VAERS Form:2
Age:28.0
Sex:Male
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood pressure increased, Chest pain, Echocardiogram normal, Fibrin D dimer decreased, Myocarditis, Ventilation/perfusion scan, Computerised tomogram thorax normal, Scan with contrast normal, Myocardial necrosis marker increased, Magnetic resonance imaging normal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Guafacine 1mg 2x day bystolic 10 mg 1x day Rousavastin 10mg 1x day
Current Illness: Autism, hypentsion
Preexisting Conditions: Austism
Allergies: Iodine contrast dye
Diagnostic Lab Data: Cardiac enzymes blood work ...as high as 17.67 ..discharged from hospital at 7.35.. ..extremely elevated Cat scan with contract...normal no blockage no damage to heart muscle D dimer test low.. .nuclear scan of lungs..no clots found Leg dabbler..no clots found Echocardiogram .. no periocarditis No trigger evidence except that Johnson and Johnson vaccine was received 5 days earlier
CDC 'Split Type':

Write-up: Chest pain, Elevated blood pressure, elevated cardiac enzymes, Acute myocarditis


Changed on 5/7/2021

VAERS ID: 1227834 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood pressure increased, Chest pain, Echocardiogram normal, Fibrin D dimer decreased, Myocarditis, Ventilation/perfusion scan, Computerised tomogram thorax normal, Scan with contrast normal, Myocardial necrosis marker increased, Magnetic resonance imaging normal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Guafacine 1mg 2x day bystolic 10 mg 1x day Rousavastin 10mg 1x day
Current Illness: Autism, hypentsion
Preexisting Conditions: Austism
Allergies: Iodine contrast dye dye
Diagnostic Lab Data: Cardiac enzymes blood work ...as high as 17.67 ..discharged from hospital at 7.35.. ..extremely elevated Cat scan with contract...normal no blockage no damage to heart muscle D dimer test low.. .nuclear scan of lungs..no clots found Leg dabbler..no clots found Echocardiogram .. no periocarditis No trigger evidence except that Johnson and Johnson vaccine was received 5 days earlier
CDC 'Split Type':

Write-up: Chest pain, Elevated blood pressure, elevated cardiac enzymes, Acute myocarditis


Changed on 5/14/2021

VAERS ID: 1227834 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood pressure increased, Chest pain, Echocardiogram normal, Fibrin D dimer decreased, Myocarditis, Ventilation/perfusion scan, Computerised tomogram thorax normal, Scan with contrast normal, Myocardial necrosis marker increased, Magnetic resonance imaging normal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Guafacine 1mg 2x day bystolic 10 mg 1x day Rousavastin 10mg 1x day
Current Illness: Autism, hypentsion
Preexisting Conditions: Austism
Allergies: Iodine contrast dye dye
Diagnostic Lab Data: Cardiac enzymes blood work ...as high as 17.67 ..discharged from hospital at 7.35.. ..extremely elevated Cat scan with contract...normal no blockage no damage to heart muscle D dimer test low.. .nuclear scan of lungs..no clots found Leg dabbler..no clots found Echocardiogram .. no periocarditis No trigger evidence except that Johnson and Johnson vaccine was received 5 days earlier
CDC 'Split Type':

Write-up: Chest pain, Elevated blood pressure, elevated cardiac enzymes, Acute myocarditis

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1227834&WAYBACKHISTORY=ON


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