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This is VAERS ID 1230864

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1230864
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Influenza like illness, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210425102

Write-up: FLU LIKE SYMPTOMS(LOW GRADE FEVER, BODY ACHE, HEADACHE, CHILLS); NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-APR-2021 10:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-APR-2021, the subject experienced flu like symptoms (low grade fever, body ache, headache, chills). On 11-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the flu like symptoms(low grade fever, body ache, headache, chills) and nausea was not reported. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1230864 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Influenza like illness, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210425102

Write-up: FLU LIKE SYMPTOMS(LOW GRADE FEVER, BODY ACHE, HEADACHE, CHILLS); NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-APR-2021 10:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-APR-2021, the subject experienced flu like symptoms (low grade fever, body ache, headache, chills). On 11-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the flu like symptoms(low grade fever, body ache, headache, chills) and nausea was not reported. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1230864 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Influenza like illness, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210425102

Write-up: FLU LIKE SYMPTOMS(LOW GRADE FEVER, BODY ACHE, HEADACHE, CHILLS); NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-APR-2021 10:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-APR-2021, the subject experienced flu like symptoms (low grade fever, body ache, headache, chills). On 11-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the flu like symptoms(low grade fever, body ache, headache, chills) and nausea was not reported. This report was non-serious.

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