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 1225311



Case Details

VAERS ID: 1225311 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-15
Onset:2021-04-11
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Physical examination
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Lexapro, Abilify, Senna-S, Miralax
Current Illness: Hypothyroidism, primary progressive aphasia.
Preexisting Conditions: Hypothyroidism, primary progressive aphasia.
Allergies: No known drug or food allergies.
Diagnostic Lab Data: UNABLE TO EVALUATE OTHER THAN PHYSICAL EXAM AT PATIENT HOME BY SUPPORTING MEDICAL TEAM.
CDC Split Type:

Write-up: SUDDEN ONSET OF SWELLING IN ENTIRE LEFT LOWER EXTREMITY ON APRIL 11, 2021. NO RECENT TRAUMA , CHANGE IN AMBULATORY STATUS OR CHANGE IN HYDRATION OR ORAL INTAKE.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1225311


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