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This is VAERS ID 1243073

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1243073
VAERS Form:2
Age:78.0
Sex:Male
Location:Oregon
Vaccinated:2021-04-11
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Neck pain, Sleep disorder

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: Acetaminophen Apixaban Diltiazem Lisinopril Metoprolol Rosuvastatin Vitamin D3 Travoprost ophthalmic drops Furosemide Fish Oil Potassium Tramadol
Current Illness: None
Preexisting Conditions: Afib, HTN, prostate CA, and glaucoma.
Allergies: No known medication or food allergies.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient has been having severe neck pain (b/l right below ears) and severe bilateral shoulder pain since 04/12/21 (the day after his Johnson and Johnson COVID vaccine). Patient has been unable to sleep due to the severe pain. Patient was given some PO pain medication from his PCP and has not been able to get any relief.


Changed on 5/14/2021

VAERS ID: 1243073 Before After
VAERS Form:2
Age:78.0
Sex:Male
Location:Oregon
Vaccinated:2021-04-11
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Neck pain, Sleep disorder

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: Acetaminophen Apixaban Diltiazem Lisinopril Metoprolol Rosuvastatin Vitamin D3 Travoprost ophthalmic drops Furosemide Fish Oil Potassium Tramadol
Current Illness: None
Preexisting Conditions: Afib, HTN, prostate CA, and glaucoma.
Allergies: No known medication or food allergies. allergies.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient has been having severe neck pain (b/l right below ears) and severe bilateral shoulder pain since 04/12/21 (the day after his Johnson and Johnson COVID vaccine). Patient has been unable to sleep due to the severe pain. Patient was given some PO pain medication from his PCP and has not been able to get any relief.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1243073&WAYBACKHISTORY=ON


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