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This is VAERS ID 1176626

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1176626
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Eating disorder, Headache, Nausea

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: SHINGRIX
Current Illness: Autoimmune disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210356054

Write-up: NOT BEING ABLE TO EAT; NAUSEA; DIARRHEA; HEADACHE; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included autoimmune disease. The patient received Covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1802068, and expiry: UNKNOWN),vaccinated at right arm, dose was not reported, administered on 22-MAR-2021 for prophylactic vaccination. Concomitant medications included varicella zoster vaccine. On 28-MAR-2021, the subject experienced headache. On 28-MAR-2021 03:00, the subject experienced diarrhea, nausea. On an unspecified date, the subject experienced not being able to eat. The action taken with Covid-19 vaccine was not applicable. The patient recovered from diarrhea, and nausea on 29-MAR-2021, was recovering from headache, and the outcome of not being able to eat was not reported. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1176626 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Eating disorder, Headache, Nausea

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: SHINGRIX
Current Illness: Autoimmune disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210356054

Write-up: NOT BEING ABLE TO EAT; NAUSEA; DIARRHEA; HEADACHE; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included autoimmune disease. The patient received Covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1802068, and expiry: UNKNOWN),vaccinated at right arm, dose was not reported, administered on 22-MAR-2021 for prophylactic vaccination. Concomitant medications included varicella zoster vaccine. On 28-MAR-2021, the subject experienced headache. On 28-MAR-2021 03:00, the subject experienced diarrhea, nausea. On an unspecified date, the subject experienced not being able to eat. The action taken with Covid-19 vaccine was not applicable. The patient recovered from diarrhea, and nausea on 29-MAR-2021, was recovering from headache, and the outcome of not being able to eat was not reported. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1176626 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Eating disorder, Headache, Nausea

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: SHINGRIX
Current Illness: Autoimmune disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210356054

Write-up: NOT BEING ABLE TO EAT; NAUSEA; DIARRHEA; HEADACHE; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included autoimmune disease. The patient received Covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1802068, and expiry: UNKNOWN),vaccinated at right arm, dose was not reported, administered on 22-MAR-2021 for prophylactic vaccination. Concomitant medications included varicella zoster vaccine. On 28-MAR-2021, the subject experienced headache. On 28-MAR-2021 03:00, the subject experienced diarrhea, nausea. On an unspecified date, the subject experienced not being able to eat. The action taken with Covid-19 vaccine was not applicable. The patient recovered from diarrhea, and nausea on 29-MAR-2021, was recovering from headache, and the outcome of not being able to eat was not reported. This report was non-serious.

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