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This is VAERS ID 1262527

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1262527
VAERS Form:2
Age:42.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-01
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocardial infarction, Myocarditis, Pulmonary thrombosis, Vomiting

Life Threatening? Yes
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 70/30 Humalog atenolol lisinopril bupropion clopidogrel
Current Illness: none
Preexisting Conditions: heat attack in o5, o7, stroke 10-30-21
Allergies: sea food metformin penicillin
Diagnostic Lab Data: while in te hospital i was tested for allot of things i dont remember to know for what i wqas not told
CDC 'Split Type':

Write-up: on the 2nd i had the shot in the left upper arm .. two days later i woke up to violently upchucking pure water after that i when to hospital and was admited i was told after a ekg that i was haveing a heart attack after that have no recolectiom of anything i wake up to a doc telling ,e it was a bad heart attack and had delovped about 5 blod clots in left lung and microcaditis i have been trying since then for a doc to talk to me but so far i been avoided


Changed on 5/7/2021

VAERS ID: 1262527 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-01
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocardial infarction, Myocarditis, Pulmonary thrombosis, Vomiting

Life Threatening? Yes
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 70/30 Humalog atenolol lisinopril bupropion clopidogrel
Current Illness: none
Preexisting Conditions: heat attack in o5, o7, stroke 10-30-21
Allergies: sea food metformin penicillin penicillin
Diagnostic Lab Data: while in te hospital i was tested for allot of things i dont remember to know for what i wqas not told
CDC 'Split Type':

Write-up: on the 2nd i had the shot in the left upper arm .. two days later i woke up to violently upchucking pure water after that i when to hospital and was admited i was told after a ekg that i was haveing a heart attack after that have no recolectiom of anything i wake up to a doc telling ,e it was a bad heart attack and had delovped about 5 blod clots in left lung and microcaditis i have been trying since then for a doc to talk to me but so far i been avoided


Changed on 5/14/2021

VAERS ID: 1262527 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-01
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Myocardial infarction, Myocarditis, Pulmonary thrombosis, Vomiting

Life Threatening? Yes
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 70/30 Humalog atenolol lisinopril bupropion clopidogrel
Current Illness: none
Preexisting Conditions: heat attack in o5, o7, stroke 10-30-21
Allergies: sea food metformin penicillin penicillin
Diagnostic Lab Data: while in te hospital i was tested for allot of things i dont remember to know for what i wqas not told
CDC 'Split Type':

Write-up: on the 2nd i had the shot in the left upper arm .. two days later i woke up to violently upchucking pure water after that i when to hospital and was admited i was told after a ekg that i was haveing a heart attack after that have no recolectiom of anything i wake up to a doc telling ,e it was a bad heart attack and had delovped about 5 blod clots in left lung and microcaditis i have been trying since then for a doc to talk to me but so far i been avoided

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