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This is VAERS ID 1266358

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1266358
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Cough, Dyspnoea, Vomiting, Decreased appetite, Oesophageal motility disorder, Illness, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bumex, albuterol, Pulmicort, carvedilol, Cardizem, Lexapro, Vytorin, flucticasone-umeclidin-vilant, formoterol fumarate, Norco, insulin, levothyroxine, omeprazole, ramipril, spironolactone
Current Illness:
Preexisting Conditions: Arthritis, asthma, B12 deficiency, cardiomyopathy, chronic lumbar pain, COPD, depression, dyslipidemia, GERD, hiatal hernia, history of thyroid cancer, hypertension, hypothyroidism, incontinence, obesity, on home O2, psoriasis, thyroid disease, venous insufficiency
Allergies: Sulfa antibiotics
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB Antigens, POC: Positive (4/23/2021)
CDC 'Split Type':

Write-up: 80y.o. female with past medical history of COPD on 3L O2 at home, Asthma, Arthritis, B12 deficiency, Depression, GERD, Achalasia, HTN and Hypothyroidism presented with a chief complaint of cough and weakness. Patient states that she had the Johnson & Johnson vaccine on March 11th 2021 and believes she got sick from it. Since getting the vaccine, whenever she eats something she begins vomiting for the next 2 days. This has happened to the patient before, as she has a history of esophageal dysmotility/achalasia. Patient began developing a cough and SOB over the last 2 weeks that are getting worse. Patient states that she has no appetite at all and is feeling very weak due to the lack of eating.


Changed on 5/7/2021

VAERS ID: 1266358 Before After
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Cough, Dyspnoea, Vomiting, Decreased appetite, Oesophageal motility disorder, Illness, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bumex, albuterol, Pulmicort, carvedilol, Cardizem, Lexapro, Vytorin, flucticasone-umeclidin-vilant, formoterol fumarate, Norco, insulin, levothyroxine, omeprazole, ramipril, spironolactone
Current Illness:
Preexisting Conditions: Arthritis, asthma, B12 deficiency, cardiomyopathy, chronic lumbar pain, COPD, depression, dyslipidemia, GERD, hiatal hernia, history of thyroid cancer, hypertension, hypothyroidism, incontinence, obesity, on home O2, psoriasis, thyroid disease, venous insufficiency
Allergies: Sulfa antibiotics antibiotics
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB Antigens, POC: Positive (4/23/2021)
CDC 'Split Type':

Write-up: 80y.o. female with past medical history of COPD on 3L O2 at home, Asthma, Arthritis, B12 deficiency, Depression, GERD, Achalasia, HTN and Hypothyroidism presented with a chief complaint of cough and weakness. Patient states that she had the Johnson & Johnson vaccine on March 11th 2021 and believes she got sick from it. Since getting the vaccine, whenever she eats something she begins vomiting for the next 2 days. This has happened to the patient before, as she has a history of esophageal dysmotility/achalasia. Patient began developing a cough and SOB over the last 2 weeks that are getting worse. Patient states that she has no appetite at all and is feeling very weak due to the lack of eating.


Changed on 5/14/2021

VAERS ID: 1266358 Before After
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Cough, Dyspnoea, Vomiting, Decreased appetite, Oesophageal motility disorder, Illness, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bumex, albuterol, Pulmicort, carvedilol, Cardizem, Lexapro, Vytorin, flucticasone-umeclidin-vilant, formoterol fumarate, Norco, insulin, levothyroxine, omeprazole, ramipril, spironolactone
Current Illness:
Preexisting Conditions: Arthritis, asthma, B12 deficiency, cardiomyopathy, chronic lumbar pain, COPD, depression, dyslipidemia, GERD, hiatal hernia, history of thyroid cancer, hypertension, hypothyroidism, incontinence, obesity, on home O2, psoriasis, thyroid disease, venous insufficiency
Allergies: Sulfa antibiotics antibiotics
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB Antigens, POC: Positive (4/23/2021)
CDC 'Split Type':

Write-up: 80y.o. female with past medical history of COPD on 3L O2 at home, Asthma, Arthritis, B12 deficiency, Depression, GERD, Achalasia, HTN and Hypothyroidism presented with a chief complaint of cough and weakness. Patient states that she had the Johnson & Johnson vaccine on March 11th 2021 and believes she got sick from it. Since getting the vaccine, whenever she eats something she begins vomiting for the next 2 days. This has happened to the patient before, as she has a history of esophageal dysmotility/achalasia. Patient began developing a cough and SOB over the last 2 weeks that are getting worse. Patient states that she has no appetite at all and is feeling very weak due to the lack of eating.

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