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This is VAERS ID 1223329

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1223329
VAERS Form:2
Age:27.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Confusional state, Gait disturbance, Influenza like illness, Migraine, Photophobia, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: High grade fever, multi hour severe migraine, light sensitivity, sharp abdominal pain, confusion, coordination/balance problems and severe flu like symptoms. Treatment was self administered and comprised fluids and bed rest.


Changed on 5/7/2021

VAERS ID: 1223329 Before After
VAERS Form:2
Age:27.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Confusional state, Gait disturbance, Influenza like illness, Migraine, Photophobia, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: High grade fever, multi hour severe migraine, light sensitivity, sharp abdominal pain, confusion, coordination/balance problems and severe flu like symptoms. Treatment was self administered and comprised fluids and bed rest.


Changed on 5/14/2021

VAERS ID: 1223329 Before After
VAERS Form:2
Age:27.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Confusional state, Gait disturbance, Influenza like illness, Migraine, Photophobia, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: High grade fever, multi hour severe migraine, light sensitivity, sharp abdominal pain, confusion, coordination/balance problems and severe flu like symptoms. Treatment was self administered and comprised fluids and bed rest.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1223329&WAYBACKHISTORY=ON


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