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This is VAERS ID 1186001

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1186001
VAERS Form:2
Age:46.0
Sex:Male
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Last week
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itching and redness


Changed on 5/7/2021

VAERS ID: 1186001 Before After
VAERS Form:2
Age:46.0
Sex:Male
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Last week
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itching and redness


Changed on 5/14/2021

VAERS ID: 1186001 Before After
VAERS Form:2
Age:46.0
Sex:Male
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Last week
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itching and redness

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1186001&WAYBACKHISTORY=ON


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