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This is VAERS ID 1350867

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1350867
VAERS Form:2
Age:34.0
Sex:Female
Location:Maine
Vaccinated:2021-05-05
Onset:2021-05-08
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Asthenia, Blood potassium decreased, Computerised tomogram normal, Fatigue, Heart rate increased, Hypertension, Palpitations, Rash, Rash erythematous, Rash pruritic, Vomiting, Troponin increased, Liver function test increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, atenolol, tegretol
Current Illness: depression, intermittent palpitations, bipolar d/o, COVID-19 + month prior to vaccine (mild)
Preexisting Conditions: depression, bipolar, intermittent palpitations
Allergies: haldol
Diagnostic Lab Data: Troponin x3 were positive Elevated LFTs Low Potassium Negative Chest CT
CDC 'Split Type':

Write-up: Day immediately following vaccine, patient was fatigued, weak, with vomiting. Day two post vaccine reported truncal rash which was itchy and red (resolved within 2 days). Day 3 patient reported palpitations and fast HR, uncontrollable HTN (160/110), been to the ER 6 times. Now taking Diltiazem, metoprolol, and hydroxyzine in addition to meds already taking.

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