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This is VAERS ID 1214065

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1214065
VAERS Form:2
Age:22.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-08
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Muscle spasms, Musculoskeletal pain, Pain in extremity, Peripheral swelling, Laboratory test

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: unknown
Current Illness:
Preexisting Conditions:
Allergies: unknown
Diagnostic Lab Data: labs drawn but no diagnostic imaging was ordered to rule out blood clot .
CDC 'Split Type':

Write-up: Patient presented to the ED and complained of bilateral posterior thigh and buttock pain. Reports the prior evening had cramping and a lump in left calf.


Changed on 5/7/2021

VAERS ID: 1214065 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-08
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Muscle spasms, Musculoskeletal pain, Pain in extremity, Peripheral swelling, Laboratory test

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: unknown
Current Illness:
Preexisting Conditions:
Allergies: unknown unknown
Diagnostic Lab Data: labs drawn but no diagnostic imaging was ordered to rule out blood clot .
CDC 'Split Type':

Write-up: Patient presented to the ED and complained of bilateral posterior thigh and buttock pain. Reports the prior evening had cramping and a lump in left calf.


Changed on 5/14/2021

VAERS ID: 1214065 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-08
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Muscle spasms, Musculoskeletal pain, Pain in extremity, Peripheral swelling, Laboratory test

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: unknown
Current Illness:
Preexisting Conditions:
Allergies: unknown unknown
Diagnostic Lab Data: labs drawn but no diagnostic imaging was ordered to rule out blood clot .
CDC 'Split Type':

Write-up: Patient presented to the ED and complained of bilateral posterior thigh and buttock pain. Reports the prior evening had cramping and a lump in left calf.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1214065&WAYBACKHISTORY=ON

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