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This is VAERS ID 1195769

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1195769
VAERS Form:2
Age:23.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Petechiae, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: small red dots on inside of right elbow-Mild, Additional Details: Patient has not sought medical attention at this time, but has a small red petichial rash on the inside of his right elbow. He thinks this may be signs of capillary leakage that have been reported with the vaccine. I advised he seek medical attention if required. No injection site issues or reactions in left arm.


Changed on 5/7/2021

VAERS ID: 1195769 Before After
VAERS Form:2
Age:23.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Petechiae, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: small red dots on inside of right elbow-Mild, Additional Details: Patient has not sought medical attention at this time, but has a small red petichial rash on the inside of his right elbow. He thinks this may be signs of capillary leakage that have been reported with the vaccine. I advised he seek medical attention if required. No injection site issues or reactions in left arm.


Changed on 5/14/2021

VAERS ID: 1195769 Before After
VAERS Form:2
Age:23.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Petechiae, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: small red dots on inside of right elbow-Mild, Additional Details: Patient has not sought medical attention at this time, but has a small red petichial rash on the inside of his right elbow. He thinks this may be signs of capillary leakage that have been reported with the vaccine. I advised he seek medical attention if required. No injection site issues or reactions in left arm.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1195769&WAYBACKHISTORY=ON

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