National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1213142

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1213142
VAERS Form:2
Age:29.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808892 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain, Gaze palsy

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: buprenorphine, gabapentin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, shell fish
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.


Changed on 5/7/2021

VAERS ID: 1213142 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808892 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain, Gaze palsy

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: buprenorphine, gabapentin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, shell fish fish
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.


Changed on 5/14/2021

VAERS ID: 1213142 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-10
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808892 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain, Gaze palsy

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: buprenorphine, gabapentin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, shell fish fish
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1213142&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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