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This is VAERS ID 1133990

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1133990
VAERS Form:2
Age:32.0
Sex:Female
Location:North Dakota
Vaccinated:2021-03-17
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Headache, Nausea

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: NONE REPORTED
Current Illness: PATIENT DID HAVE COVID BUT MORE THAN A MONTH PRIOR TO RECEIVING THE VACCINATION
Preexisting Conditions: NONE
Allergies: NONE REPORTED
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: HEADACHE, CHILLS, NAUSEA; PATIENT EXPLAINED SYMPTOMS AS BEING EXACTLY HOW SHE FELT WHEN SHE HAD COVID


Changed on 5/7/2021

VAERS ID: 1133990 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:North Dakota
Vaccinated:2021-03-17
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Headache, Nausea

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: NONE REPORTED
Current Illness: PATIENT DID HAVE COVID BUT MORE THAN A MONTH PRIOR TO RECEIVING THE VACCINATION
Preexisting Conditions: NONE
Allergies: NONE REPORTED REPORTED
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: HEADACHE, CHILLS, NAUSEA; PATIENT EXPLAINED SYMPTOMS AS BEING EXACTLY HOW SHE FELT WHEN SHE HAD COVID

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1133990&WAYBACKHISTORY=ON


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