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This is VAERS ID 1231130

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1231130
VAERS Form:2
Age:77.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-23
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Echocardiogram normal, Electroencephalogram normal, Generalised tonic-clonic seizure, Laboratory test normal, Scan with contrast, Ultrasound scan normal, Computerised tomogram head abnormal, Magnetic resonance imaging head 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)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/Hctz, Lovastatin, Flomax, Prilosec, COq10, magnesium, zinc, D3, B12, aspirin 81mg, Flonase, MVI, Vit C
Current Illness: None
Preexisting Conditions: Elevated BP, controlled w/medication -- High cholesterol, treated with medication
Allergies: Shrimp
Diagnostic Lab Data: CT head w/contrast, MRI brain, EEG, echocardiogram, ultrasound of carotids, specific lab tests unknown. All tests were negative. All tests done between 4/11/21 and 4/19/21
CDC 'Split Type':

Write-up: Grand mal seizure while visiting daughter, length of duration unknown.


Changed on 5/7/2021

VAERS ID: 1231130 Before After
VAERS Form:2
Age:77.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-23
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Echocardiogram normal, Electroencephalogram normal, Generalised tonic-clonic seizure, Laboratory test normal, Scan with contrast, Ultrasound scan normal, Computerised tomogram head abnormal, Magnetic resonance imaging head 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)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/Hctz, Lovastatin, Flomax, Prilosec, COq10, magnesium, zinc, D3, B12, aspirin 81mg, Flonase, MVI, Vit C
Current Illness: None
Preexisting Conditions: Elevated BP, controlled w/medication -- High cholesterol, treated with medication
Allergies: Shrimp Shrimp
Diagnostic Lab Data: CT head w/contrast, MRI brain, EEG, echocardiogram, ultrasound of carotids, specific lab tests unknown. All tests were negative. All tests done between 4/11/21 and 4/19/21
CDC 'Split Type':

Write-up: Grand mal seizure while visiting daughter, length of duration unknown.


Changed on 5/14/2021

VAERS ID: 1231130 Before After
VAERS Form:2
Age:77.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-23
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Echocardiogram normal, Electroencephalogram normal, Generalised tonic-clonic seizure, Laboratory test normal, Scan with contrast, Ultrasound scan normal, Computerised tomogram head abnormal, Magnetic resonance imaging head 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)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/Hctz, Lovastatin, Flomax, Prilosec, COq10, magnesium, zinc, D3, B12, aspirin 81mg, Flonase, MVI, Vit C
Current Illness: None
Preexisting Conditions: Elevated BP, controlled w/medication -- High cholesterol, treated with medication
Allergies: Shrimp Shrimp
Diagnostic Lab Data: CT head w/contrast, MRI brain, EEG, echocardiogram, ultrasound of carotids, specific lab tests unknown. All tests were negative. All tests done between 4/11/21 and 4/19/21
CDC 'Split Type':

Write-up: Grand mal seizure while visiting daughter, length of duration unknown.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1231130&WAYBACKHISTORY=ON


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