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This is VAERS ID 1230324

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1230324
VAERS Form:2
Age:59.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-09
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Fatigue, Pain, Peripheral swelling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-31
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: Atenolol, Chlorthalidone
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None known
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)


Changed on 5/7/2021

VAERS ID: 1230324 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-09
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Fatigue, Pain, Peripheral swelling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-31
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: Atenolol, Chlorthalidone
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None known known
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)


Changed on 5/14/2021

VAERS ID: 1230324 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-09
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Fatigue, Pain, Peripheral swelling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-31
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: Atenolol, Chlorthalidone
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None known known
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230324&WAYBACKHISTORY=ON

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