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This is VAERS ID 1212310

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1212310
VAERS Form:2
Age:18.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillan
Diagnostic Lab Data: We went to hospital when his fever started to rise. They took blood and did triage, but we never saw a Dr....his fever broke on it''s own at 4:30am
CDC 'Split Type':

Write-up: High fever 104.6 at 1:30am


Changed on 5/7/2021

VAERS ID: 1212310 Before After
VAERS Form:2
Age:18.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillan amoxicillan
Diagnostic Lab Data: We went to hospital when his fever started to rise. They took blood and did triage, but we never saw a Dr....his fever broke on it''s own at 4:30am
CDC 'Split Type':

Write-up: High fever 104.6 at 1:30am


Changed on 5/14/2021

VAERS ID: 1212310 Before After
VAERS Form:2
Age:18.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillan amoxicillan
Diagnostic Lab Data: We went to hospital when his fever started to rise. They took blood and did triage, but we never saw a Dr....his fever broke on it''s own at 4:30am
CDC 'Split Type':

Write-up: High fever 104.6 at 1:30am

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212310&WAYBACKHISTORY=ON

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