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This is VAERS ID 1740847

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1740847
VAERS Form:2
Age:21.0
Sex:Male
Location:New Jersey
Vaccinated:2021-09-16
Onset:2021-09-16
Submitted:0000-00-00
Entered:2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Angina pectoris, Atrioventricular block, Chest discomfort, Costochondritis, Electrocardiogram abnormal, Fatigue, Myocarditis, Palpitations, Ultrasound scan, Magnetic resonance imaging

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)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: covid prior
Preexisting Conditions: none
Allergies: amoxicillin
Diagnostic Lab Data: EKG showed heart block, MRI and Ultrasound still pending
CDC 'Split Type':

Write-up: First day heart palpitations began along with chest tightness. Day 2 pain in heart region began developing further with continued palpitations and chest tightness. By Day 4, was admitted to ER and diagnosed with costocondritis and heart block. All symptoms remaining along with immense fatigue, cardiologist diagnosed myocarditis.

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