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This is VAERS ID 1716559

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/24/2021

VAERS ID: 1716559
VAERS Form:2
Age:20.0
Sex:Male
Location:Florida
Vaccinated:2021-09-02
Onset:2021-09-12
Submitted:0000-00-00
Entered:2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chest X-ray normal, Hypertension, Productive cough

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest X-ray clear, given IV fluids to hydrate and Tylenol.
CDC 'Split Type':

Write-up: Chest pains and violent pflemy cough, tachycardia, high blood pressure.

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