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This is VAERS ID 1136626

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1136626
VAERS Form:2
Age:68.0
Sex:Female
Location:New Jersey
Vaccinated:2021-03-24
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Chills, Headache, Influenza like illness, Pain, Pain in extremity, 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: Low Dose Asprin & Clopedril
Current Illness: Diverticulitis
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Janssen SARS-Covid-2 Vaccine Chills, fever, severe pain in left arm from shoulder to hand, body ache, headache, flu like symptoms.


Changed on 5/7/2021

VAERS ID: 1136626 Before After
VAERS Form:2
Age:68.0
Sex:Female
Location:New Jersey
Vaccinated:2021-03-24
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Chills, Headache, Influenza like illness, Pain, Pain in extremity, 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: Low Dose Asprin & Clopedril
Current Illness: Diverticulitis
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Janssen SARS-Covid-2 Vaccine Chills, fever, severe pain in left arm from shoulder to hand, body ache, headache, flu like symptoms.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1136626&WAYBACKHISTORY=ON


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