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This is VAERS ID 1131437

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1131437
VAERS Form:2
Age:16.0
Sex:Unknown
Location:Oregon
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 1808978 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is 16 years of age and should have not received the vaccine.


Changed on 5/7/2021

VAERS ID: 1131437 Before After
VAERS Form:2
Age:16.0
Sex:Unknown
Location:Oregon
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 1808978 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is 16 years of age and should have not received the vaccine.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1131437&WAYBACKHISTORY=ON


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