National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1214249

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1214249
VAERS Form:2
Age:60.0
Sex:Female
Location:Alabama
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Electrocardiogram normal, Rash

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: Nitrofurantoin
Current Illness: UTI - taking Nitrofurantoin
Preexisting Conditions: None noted
Allergies: NKDA
Diagnostic Lab Data: EKG - HR 90, normal sinus rythym
CDC 'Split Type':

Write-up: Patient presented to ER with diffuse rash over body and minimal shortness of breath. Patient received Janssen Covid vaccine the day prior. Patient also on last day of antibiotic regimen (nitrofurantoin) for urinary tract infection.


Changed on 5/7/2021

VAERS ID: 1214249 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alabama
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Electrocardiogram normal, Rash

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: Nitrofurantoin
Current Illness: UTI - taking Nitrofurantoin
Preexisting Conditions: None noted
Allergies: NKDA NKDA
Diagnostic Lab Data: EKG - HR 90, normal sinus rythym
CDC 'Split Type':

Write-up: Patient presented to ER with diffuse rash over body and minimal shortness of breath. Patient received Janssen Covid vaccine the day prior. Patient also on last day of antibiotic regimen (nitrofurantoin) for urinary tract infection.


Changed on 5/14/2021

VAERS ID: 1214249 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alabama
Vaccinated:2021-04-05
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Electrocardiogram normal, Rash

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: Nitrofurantoin
Current Illness: UTI - taking Nitrofurantoin
Preexisting Conditions: None noted
Allergies: NKDA NKDA
Diagnostic Lab Data: EKG - HR 90, normal sinus rythym
CDC 'Split Type':

Write-up: Patient presented to ER with diffuse rash over body and minimal shortness of breath. Patient received Janssen Covid vaccine the day prior. Patient also on last day of antibiotic regimen (nitrofurantoin) for urinary tract infection.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1214249&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