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This is VAERS ID 1333240

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1333240
VAERS Form:2
Age:73.0
Sex:Male
Location:California
Vaccinated:2021-04-27
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Full blood count, Myalgia, Urine analysis, Inflammation, Metabolic function test

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: asa, azelastine, cialsis, testosterone, propranolol, b-complex, zinc, copper
Current Illness: none
Preexisting Conditions: htn.
Allergies: none
Diagnostic Lab Data: cmp, cbc, ua (all done at the er)
CDC 'Split Type':

Write-up: beginning on 05/04/21 developed severe and disabling polymyalgia and poly arthralgia : was seen at urgent care twice and a local er once. we all agree this is likely an autoimmune inflammatory response to the vaccine. the patient has been placed on steroids with good response and pain reduction.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1333240&WAYBACKHISTORY=ON


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