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This is VAERS ID 1131491

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1131491
VAERS Form:2
Age:15.0
Sex:Male
Location:Michigan
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 1808609 / 1 LA / IM

Administered by: Pharmacy      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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccine was not approved in this age group. Only approved for 18+.


Changed on 5/7/2021

VAERS ID: 1131491 Before After
VAERS Form:2
Age:15.0
Sex:Male
Location:Michigan
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 1808609 / 1 LA / IM

Administered by: Pharmacy      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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccine was not approved in this age group. Only approved for 18+.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1131491&WAYBACKHISTORY=ON


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