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This is VAERS ID 1135353

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1135353
VAERS Form:2
Age:55.0
Sex:Male
Location:Florida
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Other      Purchased by: ??
Symptoms: Hepatitis B immunisation, Inappropriate schedule of product administration

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: unknown
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: no known allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Client denied in written format and verbally that he received any other vaccinations 14 days prior to receiving the COVID vaccination. Client had received Hep B (HEPLISAV-B) on 3/18/2021


Changed on 5/7/2021

VAERS ID: 1135353 Before After
VAERS Form:2
Age:55.0
Sex:Male
Location:Florida
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Other      Purchased by: ??
Symptoms: Hepatitis B immunisation, Inappropriate schedule of product administration

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: unknown
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: no known allergies allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Client denied in written format and verbally that he received any other vaccinations 14 days prior to receiving the COVID vaccination. Client had received Hep B (HEPLISAV-B) on 3/18/2021

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1135353&WAYBACKHISTORY=ON


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