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This is VAERS ID 1665435

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First Appeared on 9/3/2021

VAERS ID: 1665435
VAERS Form:2
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Catheterisation cardiac, Electrocardiogram, Headache, Malaise, 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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (consumption of beer); Blood pressure high; Diabetes; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and no history of drug abuse or illicit drug usage. The patient had no heart problems.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Cardiac catheterisation; Result Unstructured Data: everything looks fine with heart but have pericarditis; Test Date: 202104; Test Name: Electrocardiogram; Result Unstructured Data: not reported
CDC 'Split Type': USJNJFOC20210860091

Write-up: PERICARDITIS; HEADACHE; UNWELL FEELING; This spontaneous report received from a patient concerned a 70 year (69 year at the time of vaccination) old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: high blood pressure but under control, diabetes but under control, alcohol user, and non smoker, and other pre-existing medical conditions included: The patient had no known allergies and no history of drug abuse or illicit drug usage. The patient had no heart problems. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802072, expiry: UNKNOWN) dose was not reported, 1 total, administered on 12-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. The patient was not feeling well for 3 weeks after vaccination. The patient indicated he was experiencing headaches and was not feeling well about 1 week prior hospitalization. The patient had thought that he had Covid and went to urgent care. Then patient had underwent an electrocardiogram test and everyone thought patient was had heart attack. After that patient underwent catheterization procedure which had indicated everything fine with patient''s heart but diagnosed with pericarditis. On 9-APR-2021, patient was hospitalized for pericarditis, unwell feeling and headaches. On 10-APR-2021, the patient was discharged from hospital (Duration of hospitalization was 1 day). The patient had indicated that he was still taking colchicine twice a day for this condition. The patient had visited the cardiologist after he was released from hospital. He was told by his cardiologist that the pericarditis was a virus which can get anywhere in the body. The patient did not feel that the pericarditis was related to the vaccine and because patient believed it would had happened earlier. The patient had a follow up with his cardiologist in OCT-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pericarditis, and the outcome of unwell feeling and headache was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210860091-Covid-19 vaccine ad26.cov2.s-Pericarditis. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210860091-Covid-19 vaccine ad26.cov2.s-Unwell feeling, Headache. This event(s) is labeled per RSI and is therefore considered potentially related.

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