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This is VAERS ID 1617821

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1617821
VAERS Form:2
Age:33.0
Sex:Male
Location:New York
Vaccinated:2021-07-23
Onset:2021-08-20
Submitted:0000-00-00
Entered:2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Acute myocardial infarction, Pericarditis, Electrocardiogram ST-T change, Troponin, Myocardial necrosis marker increased

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: HS trop 1 hr 98, 3 hr 73 and delta change 33. Also nonspecific st changes on ekg at admission 8/20/2021
CDC 'Split Type':

Write-up: poss NSTEMI/pericarditis elevated cardiac enzymes

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