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This is VAERS ID 1301746

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1301746
VAERS Form:2
Age:43.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Pain, Pharyngeal swelling

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? No
Previous Vaccinations:
Other Medications: SOTALOL; METOPROLOL; ELIQUIS
Current Illness: Atrial fibrillation; Hereditary angioedema
Preexisting Conditions: Comments: The patient did not have any known allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210505450

Write-up: BODY ACHES; THROAT SWELLING; This spontaneous report received from a patient concerned a 43 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hereditary angioedema, and atrial fibrillation, and other pre-existing medical conditions included the patient did not have any known allergies. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 02-MAY-2021 for prophylactic vaccination. Concomitant medications included apixaban for atrial fibrillation, metoprolol for atrial fibrillation, and sotalol for atrial fibrillation. On 02-MAY-2021, the subject experienced throat swelling. On 03-MAY-2021, the subject experienced body aches. Treatment medications (dates unspecified) included: icatibant acetate. The action taken with covid-19 was not applicable. The patient recovered from throat swelling on 02-MAY-2021, and had not recovered from body aches. This report was non-serious.

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