National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1090297

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1090297
VAERS Form:2
Age:21.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Fatigue, Heart rate increased, Nausea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test negative

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: small fever
Preexisting Conditions: tachycardia
Allergies: Sulfa
Diagnostic Lab Data: rapid covid test and PCR covid test was done on 3/6/21, came back negative
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA day after had fever that went to 103, extreme fatigue and nausea, oxygen went down to 91 briefly, and heart rate in the 150s while resting.


Changed on 5/7/2021

VAERS ID: 1090297 Before After
VAERS Form:2
Age:21.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Fatigue, Heart rate increased, Nausea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test negative

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: small fever
Preexisting Conditions: tachycardia
Allergies: Sulfa Sulfa
Diagnostic Lab Data: rapid covid test and PCR covid test was done on 3/6/21, came back negative
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA day after had fever that went to 103, extreme fatigue and nausea, oxygen went down to 91 briefly, and heart rate in the 150s while resting.


Changed on 5/14/2021

VAERS ID: 1090297 Before After
VAERS Form:2
Age:21.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Fatigue, Heart rate increased, Nausea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test negative

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: small fever
Preexisting Conditions: tachycardia
Allergies: Sulfa Sulfa
Diagnostic Lab Data: rapid covid test and PCR covid test was done on 3/6/21, came back negative
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA day after had fever that went to 103, extreme fatigue and nausea, oxygen went down to 91 briefly, and heart rate in the 150s while resting.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1090297&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166