National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/4/2021 release of VAERS data:

This is VAERS ID 1222436



Case Details

VAERS ID: 1222436 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: moderate fatigue, moderate pain at injection site, Influenza A vaccine, 54 years old, date approximately January 2021.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Bactrim
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Severe Chills on 11 April 2021 at 1:30 am, duration approximately 90 minutes. Self-administered ibuprofen. Resolved. Moderate to severe headache from 11 April 2021 to 12 April 2021. Treated with ibupofen. Resolved. Mild nausea, interrmittent from 11 April 2021 to 17 April 2021. Untreated, currently ongoing.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1222436


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