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This is VAERS ID 1351581

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1351581
VAERS Form:2
Location:New Jersey
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Burning sensation, Cardiovascular disorder, Death, Flank pain, Muscle spasms, Pain, Pain in extremity, Skin discolouration, Unresponsive to stimuli, Impaired driving ability

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-16
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: Neurontin, Mobic, Lexapro, Xanax
Current Illness: Prior to Janssen Covid-19 Vaccine/Bronchitis, UTI
Preexisting Conditions: Melanoma, Chronic Lymphatic Leukemia... Received Immunotherapy in 2018
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating pain to Left Thigh. Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine

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