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This is VAERS ID 1247290

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247290
VAERS Form:2
Age:62.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / -

Administered by: Other      Purchased by: ??
Symptoms: Aortic aneurysm rupture, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-12
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: paraphenylenediamine (PPD)-hair dying products
Diagnostic Lab Data: Coroner''s Bureau - County Sheriff''s Office said that the reason of death is ruptured aortic aneurysm caused by high blood pressure. They didn''t give a report yet. You can call Coroner''s Bureau County Sheriff''s Office for more info.
CDC 'Split Type':

Write-up: He found dead after 2 days he got the vaccine.


Changed on 5/7/2021

VAERS ID: 1247290 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / -

Administered by: Other      Purchased by: ??
Symptoms: Aortic aneurysm rupture, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-12
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: paraphenylenediamine (PPD)-hair dying products products
Diagnostic Lab Data: Coroner''s Bureau - County Sheriff''s Office said that the reason of death is ruptured aortic aneurysm caused by high blood pressure. They didn''t give a report yet. You can call Coroner''s Bureau County Sheriff''s Office for more info.
CDC 'Split Type':

Write-up: He found dead after 2 days he got the vaccine.


Changed on 5/14/2021

VAERS ID: 1247290 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / -

Administered by: Other      Purchased by: ??
Symptoms: Aortic aneurysm rupture, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-12
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: paraphenylenediamine (PPD)-hair dying products products
Diagnostic Lab Data: Coroner''s Bureau - County Sheriff''s Office said that the reason of death is ruptured aortic aneurysm caused by high blood pressure. They didn''t give a report yet. You can call Coroner''s Bureau County Sheriff''s Office for more info.
CDC 'Split Type':

Write-up: He found dead after 2 days he got the vaccine.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247290&WAYBACKHISTORY=ON

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