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This is VAERS ID 1230884

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1230884
VAERS Form:2
Age:
Sex:Male
Location:Pennsylvania
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 205A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Fatigue, Influenza like illness, Pain

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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210427571

Write-up: FLU LIKE SYMPTOMS; MINOR BODY ACHE; FATIGUE; DIARRHEA; This spontaneous report received from a patient concerned a 38 year old male. 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: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced diarrhea. On 11-APR-2021, the subject experienced minor body ache. On 11-APR-2021, the subject experienced fatigue. On an unspecified date, the subject experienced flu like symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, and fatigue on 12-APR-2021, and the outcome of flu like symptoms and minor body ache was not reported. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1230884 Before After
VAERS Form:2
Age:
Sex:Male
Location:Pennsylvania
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 205A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Fatigue, Influenza like illness, Pain

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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210427571

Write-up: FLU LIKE SYMPTOMS; MINOR BODY ACHE; FATIGUE; DIARRHEA; This spontaneous report received from a patient concerned a 38 year old male. 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: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced diarrhea. On 11-APR-2021, the subject experienced minor body ache. On 11-APR-2021, the subject experienced fatigue. On an unspecified date, the subject experienced flu like symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, and fatigue on 12-APR-2021, and the outcome of flu like symptoms and minor body ache was not reported. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1230884 Before After
VAERS Form:2
Age:
Sex:Male
Location:Pennsylvania
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 205A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Fatigue, Influenza like illness, Pain

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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210427571

Write-up: FLU LIKE SYMPTOMS; MINOR BODY ACHE; FATIGUE; DIARRHEA; This spontaneous report received from a patient concerned a 38 year old male. 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: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced diarrhea. On 11-APR-2021, the subject experienced minor body ache. On 11-APR-2021, the subject experienced fatigue. On an unspecified date, the subject experienced flu like symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, and fatigue on 12-APR-2021, and the outcome of flu like symptoms and minor body ache was not reported. This report was non-serious.

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