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This is VAERS ID 1243858

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1243858
VAERS Form:2
Age:51.0
Sex:Male
Location:Florida
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase increased, Anion gap normal, Aspartate aminotransferase increased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood lactic acid, Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Carbon dioxide normal, Dyspnoea, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, International normalised ratio increased, Mean cell haemoglobin increased, Mean cell volume normal, Oxygen saturation decreased, Platelet count normal, PO2 decreased, Protein total increased, Prothrombin time prolonged, Red blood cell count normal, White blood cell count increased, Continuous positive airway pressure, Red cell distribution width increased, PCO2 normal, Fraction of inspired oxygen, Base excess increased, COVID-19, SARS-CoV-2 test positive, Occupational exposure to SARS-CoV-2

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin-dose unknown Metoprolol-dose unknown Pantoprazole-dose unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension GERD High Cholesterol Obesity Diabetes-NIDDM
Allergies: No known drug allergies
Diagnostic Lab Data: sodium 141; potassium 3.8; chloride 103; carbon dioxide 29.1; glucose 164; bun 22; serum creatinine 1.5; calcium 9.1; anion gap 8.9; eGFR non-african american 49; eGFR african american 60; total protein 8.4; albumin 2.6; bilirubin-total 0.5; alkaline phos 63; SGOT(AST) 43; SGPT (ALT) 82; WBC 17.1; RBC COUNT 5.25; Hemoglobin 15.8; Hematocrit 47.6; MCV 91; MCH 33.2; RDW 14.7; Platelet count 348,000; lactic acid 3.0; PT 14.4; INR 1.3; PTT 34; FiO2 100%; pH 7.455; pCO2 40.20; pO2 58.30; Base excess 4; HCO3 28.20; O2 sat 90%
CDC 'Split Type':

Write-up: Patient states that he received Janssen Covid-19 vaccine on 3/31/2021 and was exposed to a covid-19 positive co-worker on 4/2/2021 and tested positive for Covid-19 on 4-10-2021. The patient came to the hospital emergency room via EMS on 4/21/2021 at 0912 complaining of shortness of breath. According to EMS the patient had an O2 saturation of 57% on room air and was place on CPAP, 15 liters, and transported to the ER.


Changed on 5/7/2021

VAERS ID: 1243858 Before After
VAERS Form:2
Age:51.0
Sex:Male
Location:Florida
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase increased, Anion gap normal, Aspartate aminotransferase increased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood lactic acid, Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Carbon dioxide normal, Dyspnoea, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, International normalised ratio increased, Mean cell haemoglobin increased, Mean cell volume normal, Oxygen saturation decreased, Platelet count normal, PO2 decreased, Protein total increased, Prothrombin time prolonged, Red blood cell count normal, White blood cell count increased, Continuous positive airway pressure, Red cell distribution width increased, PCO2 normal, Fraction of inspired oxygen, Base excess increased, COVID-19, SARS-CoV-2 test positive, Occupational exposure to SARS-CoV-2

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin-dose unknown Metoprolol-dose unknown Pantoprazole-dose unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension GERD High Cholesterol Obesity Diabetes-NIDDM
Allergies: No known drug allergies allergies
Diagnostic Lab Data: sodium 141; potassium 3.8; chloride 103; carbon dioxide 29.1; glucose 164; bun 22; serum creatinine 1.5; calcium 9.1; anion gap 8.9; eGFR non-african american 49; eGFR african american 60; total protein 8.4; albumin 2.6; bilirubin-total 0.5; alkaline phos 63; SGOT(AST) 43; SGPT (ALT) 82; WBC 17.1; RBC COUNT 5.25; Hemoglobin 15.8; Hematocrit 47.6; MCV 91; MCH 33.2; RDW 14.7; Platelet count 348,000; lactic acid 3.0; PT 14.4; INR 1.3; PTT 34; FiO2 100%; pH 7.455; pCO2 40.20; pO2 58.30; Base excess 4; HCO3 28.20; O2 sat 90%
CDC 'Split Type':

Write-up: Patient states that he received Janssen Covid-19 vaccine on 3/31/2021 and was exposed to a covid-19 positive co-worker on 4/2/2021 and tested positive for Covid-19 on 4-10-2021. The patient came to the hospital emergency room via EMS on 4/21/2021 at 0912 complaining of shortness of breath. According to EMS the patient had an O2 saturation of 57% on room air and was place on CPAP, 15 liters, and transported to the ER.


Changed on 5/14/2021

VAERS ID: 1243858 Before After
VAERS Form:2
Age:51.0
Sex:Male
Location:Florida
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase increased, Anion gap normal, Aspartate aminotransferase increased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood lactic acid, Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Carbon dioxide normal, Dyspnoea, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, International normalised ratio increased, Mean cell haemoglobin increased, Mean cell volume normal, Oxygen saturation decreased, Platelet count normal, PO2 decreased, Protein total increased, Prothrombin time prolonged, Red blood cell count normal, White blood cell count increased, Continuous positive airway pressure, Red cell distribution width increased, PCO2 normal, Fraction of inspired oxygen, Base excess increased, COVID-19, SARS-CoV-2 test positive, Occupational exposure to SARS-CoV-2

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin-dose unknown Metoprolol-dose unknown Pantoprazole-dose unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension GERD High Cholesterol Obesity Diabetes-NIDDM
Allergies: No known drug allergies allergies
Diagnostic Lab Data: sodium 141; potassium 3.8; chloride 103; carbon dioxide 29.1; glucose 164; bun 22; serum creatinine 1.5; calcium 9.1; anion gap 8.9; eGFR non-african american 49; eGFR african american 60; total protein 8.4; albumin 2.6; bilirubin-total 0.5; alkaline phos 63; SGOT(AST) 43; SGPT (ALT) 82; WBC 17.1; RBC COUNT 5.25; Hemoglobin 15.8; Hematocrit 47.6; MCV 91; MCH 33.2; RDW 14.7; Platelet count 348,000; lactic acid 3.0; PT 14.4; INR 1.3; PTT 34; FiO2 100%; pH 7.455; pCO2 40.20; pO2 58.30; Base excess 4; HCO3 28.20; O2 sat 90%
CDC 'Split Type':

Write-up: Patient states that he received Janssen Covid-19 vaccine on 3/31/2021 and was exposed to a covid-19 positive co-worker on 4/2/2021 and tested positive for Covid-19 on 4-10-2021. The patient came to the hospital emergency room via EMS on 4/21/2021 at 0912 complaining of shortness of breath. According to EMS the patient had an O2 saturation of 57% on room air and was place on CPAP, 15 liters, and transported to the ER.

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