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This is VAERS ID 1129048

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1129048
VAERS Form:2
Age:18.0
Sex:Male
Location:Louisiana
Vaccinated:2021-03-23
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Headache, Nausea, Pyrexia, Tenderness

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 60mg, Singulair 10mg, Xyzal
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Headache, fever 100.2, nausea & arm tenderness. Took Advil.


Changed on 5/7/2021

VAERS ID: 1129048 Before After
VAERS Form:2
Age:18.0
Sex:Male
Location:Louisiana
Vaccinated:2021-03-23
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Headache, Nausea, Pyrexia, Tenderness

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 60mg, Singulair 10mg, Xyzal
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Headache, fever 100.2, nausea & arm tenderness. Took Advil.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1129048&WAYBACKHISTORY=ON


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