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This is VAERS ID 1430160

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430160
VAERS Form:2
Age:18.0
Sex:Female
Location:Texas
Vaccinated:2021-04-02
Onset:2021-04-26
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray normal, Electrocardiogram normal, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: melatonin 5mg qd
Current Illness:
Preexisting Conditions: atopic triad
Allergies: fish sauce
Diagnostic Lab Data: EKG, normal; chest x-ray, normal
CDC 'Split Type':

Write-up: Pericarditis, treated OTC

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