National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1185288

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185288
VAERS Form:2
Age:18.0
Sex:Male
Location:Colorado
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: Unknown      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Nobe
CDC 'Split Type':

Write-up: High fever, Fatigue, Headache, Pain at injection site


Changed on 5/7/2021

VAERS ID: 1185288 Before After
VAERS Form:2
Age:18.0
Sex:Male
Location:Colorado
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: Unknown      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Penicillin
Diagnostic Lab Data: Nobe
CDC 'Split Type':

Write-up: High fever, Fatigue, Headache, Pain at injection site


Changed on 5/14/2021

VAERS ID: 1185288 Before After
VAERS Form:2
Age:18.0
Sex:Male
Location:Colorado
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: Unknown      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Penicillin
Diagnostic Lab Data: Nobe
CDC 'Split Type':

Write-up: High fever, Fatigue, Headache, Pain at injection site

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185288&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166