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This is VAERS ID 1233116

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1233116
VAERS Form:2
Age:36.0
Sex:Male
Location:Connecticut
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Headache, Nausea, Pain in extremity, Laboratory test normal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin B-Complex, Melatonin, Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG and chest X-ray performed, both clear. Cardiac enzyme and other basic blood test all within normal range. Blood pressure slightly elevated (continuing).
CDC 'Split Type':

Write-up: Leg pain, pressure headaches and chest tightness resulting in ER visit 4/12. Attending physician noted no visible signs of clots. Occasional shortness of breath and brief bursts of dizziness and nausea (not necessarily together) persist, as do minor headaches.


Changed on 5/7/2021

VAERS ID: 1233116 Before After
VAERS Form:2
Age:36.0
Sex:Male
Location:Connecticut
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Headache, Nausea, Pain in extremity, Laboratory test normal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin B-Complex, Melatonin, Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: EKG and chest X-ray performed, both clear. Cardiac enzyme and other basic blood test all within normal range. Blood pressure slightly elevated (continuing).
CDC 'Split Type':

Write-up: Leg pain, pressure headaches and chest tightness resulting in ER visit 4/12. Attending physician noted no visible signs of clots. Occasional shortness of breath and brief bursts of dizziness and nausea (not necessarily together) persist, as do minor headaches.


Changed on 5/14/2021

VAERS ID: 1233116 Before After
VAERS Form:2
Age:36.0
Sex:Male
Location:Connecticut
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Headache, Nausea, Pain in extremity, Laboratory test normal, Myocardial necrosis marker normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin B-Complex, Melatonin, Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: EKG and chest X-ray performed, both clear. Cardiac enzyme and other basic blood test all within normal range. Blood pressure slightly elevated (continuing).
CDC 'Split Type':

Write-up: Leg pain, pressure headaches and chest tightness resulting in ER visit 4/12. Attending physician noted no visible signs of clots. Occasional shortness of breath and brief bursts of dizziness and nausea (not necessarily together) persist, as do minor headaches.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1233116&WAYBACKHISTORY=ON


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