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This is VAERS ID 1223418

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1223418
VAERS Form:2
Age:53.0
Sex:Male
Location:Georgia
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tadalafil 10mg 1 po prn
Current Illness: GI illness 3/17/2021
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports he feels like he cannot get out of bed. The symptoms started the evening of the vaccine and have continued through the reporting date (4/17/2021)


Changed on 5/7/2021

VAERS ID: 1223418 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Georgia
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tadalafil 10mg 1 po prn
Current Illness: GI illness 3/17/2021
Preexisting Conditions: None
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports he feels like he cannot get out of bed. The symptoms started the evening of the vaccine and have continued through the reporting date (4/17/2021)


Changed on 5/14/2021

VAERS ID: 1223418 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Georgia
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tadalafil 10mg 1 po prn
Current Illness: GI illness 3/17/2021
Preexisting Conditions: None
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports he feels like he cannot get out of bed. The symptoms started the evening of the vaccine and have continued through the reporting date (4/17/2021)

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1223418&WAYBACKHISTORY=ON


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