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This is VAERS ID 1620492

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1620492
VAERS Form:2
Age:45.0
Sex:Female
Location:Montana
Vaccinated:2021-04-08
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Myocarditis, 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: age 26, seasonal flu vaccine in 2001, sickest I have ever been - blackouts, unable to walk room to room at times, out of work fo
Other Medications: daily vitamins and minerals
Current Illness: none
Preexisting Conditions: sinus arrhythmia of the heart, palpitations if blood sugar is low
Allergies: lodine, flu shot
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: myocarditis and pericarditis over the course of 5-6 weeks after the vaccines was given

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