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This is VAERS ID 1231615

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1231615
VAERS Form:2
Age:
Sex:Female
Location:Utah
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Neck mass

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': USJNJFOC20210421167

Write-up: SWOLLEN LUMP ABOVE THE COLLARBONE; This spontaneous report received from a patient concerned a 49 year old female. 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: 042A21A, and batch number: 042A21A expiry: 06-JUN-2021) dose was not reported, 1 total, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced swollen lump above the collarbone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swollen lump above the collarbone. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1231615 Before After
VAERS Form:2
Age:
Sex:Female
Location:Utah
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Neck mass

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': USJNJFOC20210421167

Write-up: SWOLLEN LUMP ABOVE THE COLLARBONE; This spontaneous report received from a patient concerned a 49 year old female. 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: 042A21A, and batch number: 042A21A expiry: 06-JUN-2021) dose was not reported, 1 total, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced swollen lump above the collarbone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swollen lump above the collarbone. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1231615 Before After
VAERS Form:2
Age:
Sex:Female
Location:Utah
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Neck mass

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': USJNJFOC20210421167

Write-up: SWOLLEN LUMP ABOVE THE COLLARBONE; This spontaneous report received from a patient concerned a 49 year old female. 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: 042A21A, and batch number: 042A21A expiry: 06-JUN-2021) dose was not reported, 1 total, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced swollen lump above the collarbone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swollen lump above the collarbone. This report was non-serious.

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