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This is VAERS ID 1171686

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1171686
VAERS Form:2
Age:30.0
Sex:Female
Location:Maryland
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arthralgia, Nausea, Neck pain, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: obesity
Allergies: NKDA
Diagnostic Lab Data: None; As above
CDC 'Split Type':

Write-up: R shoulder & neck pain started in early morning about 12 hours after vaccination with nausea & vomiting (3 times to date). Denies any fever, chills, SOB, CP, other body aches, headache, rash or diarrhea. She did eat some left-over food last night. She did not take anything except fluids for therapy. After she called to report AE this morning she was asked to go to an ED or urgent care for evaluation.


Changed on 5/7/2021

VAERS ID: 1171686 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Maryland
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arthralgia, Nausea, Neck pain, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: obesity
Allergies: NKDA NKDA
Diagnostic Lab Data: None; As above
CDC 'Split Type':

Write-up: R shoulder & neck pain started in early morning about 12 hours after vaccination with nausea & vomiting (3 times to date). Denies any fever, chills, SOB, CP, other body aches, headache, rash or diarrhea. She did eat some left-over food last night. She did not take anything except fluids for therapy. After she called to report AE this morning she was asked to go to an ED or urgent care for evaluation.


Changed on 5/14/2021

VAERS ID: 1171686 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Maryland
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arthralgia, Nausea, Neck pain, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: obesity
Allergies: NKDA NKDA
Diagnostic Lab Data: None; As above
CDC 'Split Type':

Write-up: R shoulder & neck pain started in early morning about 12 hours after vaccination with nausea & vomiting (3 times to date). Denies any fever, chills, SOB, CP, other body aches, headache, rash or diarrhea. She did eat some left-over food last night. She did not take anything except fluids for therapy. After she called to report AE this morning she was asked to go to an ED or urgent care for evaluation.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1171686&WAYBACKHISTORY=ON

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