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This is VAERS ID 1213025

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1213025
VAERS Form:2
Age:28.0
Sex:Female
Location:Washington
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest X-ray, Ear pain, Electrocardiogram, Head discomfort, Headache, Muscular weakness, Urine analysis

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol, Methylene Blue, Ketotifen oral capsule
Current Illness: no active illness at time of vaccine
Preexisting Conditions: Lyme disease, possible MS, neuropathy, chronic pain syndrome, chronic fatigue syndrome, chronic headaches/migraines
Allergies: Sulfa drugs, Codeine, Prednisone, Latex
Diagnostic Lab Data: Neuro exam, 2vw chest radiograph, Urinalysis, EKG (all done at urgent care 4/14/21)
CDC 'Split Type':

Write-up: Atypical Headache 8 days post J&J vaccine. Woke up with headache at 7:30am and the headache got progressively worse throughout the day. Headache symptoms included head pressure, ear pain, and generalized full body weakness. Went to urgent care at 6:00pm. Due to ongoing health issues it was hard for the doctor to tell if it was a reaction to the vaccine or not at the time of exam. The doctor discharged me and recommend I go to ER if symptoms progress/get worse.


Changed on 5/7/2021

VAERS ID: 1213025 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Washington
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest X-ray, Ear pain, Electrocardiogram, Head discomfort, Headache, Muscular weakness, Urine analysis

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol, Methylene Blue, Ketotifen oral capsule
Current Illness: no active illness at time of vaccine
Preexisting Conditions: Lyme disease, possible MS, neuropathy, chronic pain syndrome, chronic fatigue syndrome, chronic headaches/migraines
Allergies: Sulfa drugs, Codeine, Prednisone, Latex Latex
Diagnostic Lab Data: Neuro exam, 2vw chest radiograph, Urinalysis, EKG (all done at urgent care 4/14/21)
CDC 'Split Type':

Write-up: Atypical Headache 8 days post J&J vaccine. Woke up with headache at 7:30am and the headache got progressively worse throughout the day. Headache symptoms included head pressure, ear pain, and generalized full body weakness. Went to urgent care at 6:00pm. Due to ongoing health issues it was hard for the doctor to tell if it was a reaction to the vaccine or not at the time of exam. The doctor discharged me and recommend I go to ER if symptoms progress/get worse.


Changed on 5/14/2021

VAERS ID: 1213025 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Washington
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Chest X-ray, Ear pain, Electrocardiogram, Head discomfort, Headache, Muscular weakness, Urine analysis

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol, Methylene Blue, Ketotifen oral capsule
Current Illness: no active illness at time of vaccine
Preexisting Conditions: Lyme disease, possible MS, neuropathy, chronic pain syndrome, chronic fatigue syndrome, chronic headaches/migraines
Allergies: Sulfa drugs, Codeine, Prednisone, Latex Latex
Diagnostic Lab Data: Neuro exam, 2vw chest radiograph, Urinalysis, EKG (all done at urgent care 4/14/21)
CDC 'Split Type':

Write-up: Atypical Headache 8 days post J&J vaccine. Woke up with headache at 7:30am and the headache got progressively worse throughout the day. Headache symptoms included head pressure, ear pain, and generalized full body weakness. Went to urgent care at 6:00pm. Due to ongoing health issues it was hard for the doctor to tell if it was a reaction to the vaccine or not at the time of exam. The doctor discharged me and recommend I go to ER if symptoms progress/get worse.

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