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This is VAERS ID 1184592

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1184592
VAERS Form:2
Age:69.0
Sex:Female
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Pain in extremity, 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: warfarin
Current Illness: none
Preexisting Conditions: factor v leiden
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA headache, fever, fatigue, soreness of arm - as of this date, April 9, 2021; 9:30 am. I expect to recover, but reporting these side effects for your information


Changed on 5/7/2021

VAERS ID: 1184592 Before After
VAERS Form:2
Age:69.0
Sex:Female
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Pain in extremity, 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: warfarin
Current Illness: none
Preexisting Conditions: factor v leiden
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA headache, fever, fatigue, soreness of arm - as of this date, April 9, 2021; 9:30 am. I expect to recover, but reporting these side effects for your information


Changed on 5/14/2021

VAERS ID: 1184592 Before After
VAERS Form:2
Age:69.0
Sex:Female
Location:Texas
Vaccinated:2021-04-08
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Pain in extremity, 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: warfarin
Current Illness: none
Preexisting Conditions: factor v leiden
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA headache, fever, fatigue, soreness of arm - as of this date, April 9, 2021; 9:30 am. I expect to recover, but reporting these side effects for your information

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1184592&WAYBACKHISTORY=ON


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