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This is VAERS ID 1137056

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1137056
VAERS Form:2
Age:52.0
Sex:Female
Location:Maine
Vaccinated:2021-03-25
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myalgia, Pyrexia

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: Fever and muscle aches.


Changed on 5/7/2021

VAERS ID: 1137056 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Maine
Vaccinated:2021-03-25
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myalgia, Pyrexia

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: Fever and muscle aches.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1137056&WAYBACKHISTORY=ON


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