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This is VAERS ID 1131893

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1131893
VAERS Form:2
Age:61.0
Sex:Female
Location:Indiana
Vaccinated:2021-03-24
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Headache, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Body aches (back, knees, elbows), fever, headache


Changed on 5/7/2021

VAERS ID: 1131893 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Indiana
Vaccinated:2021-03-24
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Headache, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No No
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Body aches (back, knees, elbows), fever, headache

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1131893&WAYBACKHISTORY=ON


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