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This is VAERS ID 1081451

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1081451
VAERS Form:2
Age:31.0
Sex:Female
Location:New Jersey
Vaccinated:2021-03-04
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Chills, Headache, Nausea, Pyrexia, Urine analysis, Blood test

Life Threatening? No
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)? Yes
Hospitalized? No
Previous Vaccinations: Gardasil (passed out immediately after receiving vaccine), aged 21
Other Medications: Alprazolam 0.5mg, metoprolol succinate 25mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Ceclor, stadol
Diagnostic Lab Data: Bloodwork and urinalysis (3/6/21)
CDC 'Split Type':

Write-up: Fever, chills, nausea, severe headache (still on-going), severe lower back pain (still on-going)


Changed on 5/7/2021

VAERS ID: 1081451 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:New Jersey
Vaccinated:2021-03-04
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Chills, Headache, Nausea, Pyrexia, Urine analysis, Blood test

Life Threatening? No
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)? Yes
Hospitalized? No
Previous Vaccinations: Gardasil (passed out immediately after receiving vaccine), aged 21
Other Medications: Alprazolam 0.5mg, metoprolol succinate 25mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Ceclor, stadol stadol
Diagnostic Lab Data: Bloodwork and urinalysis (3/6/21)
CDC 'Split Type':

Write-up: Fever, chills, nausea, severe headache (still on-going), severe lower back pain (still on-going)


Changed on 5/14/2021

VAERS ID: 1081451 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:New Jersey
Vaccinated:2021-03-04
Onset:2021-03-05
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Chills, Headache, Nausea, Pyrexia, Urine analysis, Blood test

Life Threatening? No
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)? Yes
Hospitalized? No
Previous Vaccinations: Gardasil (passed out immediately after receiving vaccine), aged 21
Other Medications: Alprazolam 0.5mg, metoprolol succinate 25mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Ceclor, stadol stadol
Diagnostic Lab Data: Bloodwork and urinalysis (3/6/21)
CDC 'Split Type':

Write-up: Fever, chills, nausea, severe headache (still on-going), severe lower back pain (still on-going)

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1081451&WAYBACKHISTORY=ON


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