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This is VAERS ID 1222892

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1222892
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-07
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04121A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Back pain, Chills, Diarrhoea, Pyrexia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chills, fever, searing lower back pain, diarrhea


Changed on 5/7/2021

VAERS ID: 1222892 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-07
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04121A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Back pain, Chills, Diarrhoea, Pyrexia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chills, fever, searing lower back pain, diarrhea


Changed on 5/14/2021

VAERS ID: 1222892 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-07
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04121A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Back pain, Chills, Diarrhoea, Pyrexia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chills, fever, searing lower back pain, diarrhea

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1222892&WAYBACKHISTORY=ON


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