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This is VAERS ID 1236234

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1236234
VAERS Form:2
Age:47.0
Sex:Female
Location:Wisconsin
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Dizziness, Fatigue, Hypokinesia, Malaise, Vision blurred

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: Abstains from alcohol; Cholesterol normal; Non-smoker; Varicose veins
Preexisting Conditions: Comments: No known drug allergies and had a watch on eating. Family history of varicose veins, thrombosis and blood clots. Patient is healthy and exercise regularly.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210428391

Write-up: BLURRY VISION; WEAKNESS; FELT SICK; TIRED; COULDN''T MOVE; DIZZY; This spontaneous report received from a patient concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcoholic, non-smoker, no cholesterol, and varicose veins, and other pre-existing medical conditions included no known drug allergies and had a watch on eating. family history of varicose veins, thrombosis and blood clots. patient is healthy and exercise regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, and expiry: UNKNOWN) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAR-2021, the subject experienced couldn''t move. On 16-MAR-2021, the subject experienced dizzy. On 16-MAR-2021, the subject experienced felt sick. On 16-MAR-2021, the subject experienced tired. On 18-MAR-2021, the subject experienced blurry vision. On 18-MAR-2021, the subject experienced weakness. Treatment medications (dates unspecified) included: ascorbic acid/ergocalciferol/folic acid/nicotinamide/panthenol/retinol/riboflavin/thiamine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from couldn''t move, felt sick, and tired, had not recovered from dizzy, and the outcome of blurry vision and weakness was not reported. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1236234 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Wisconsin
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Dizziness, Fatigue, Hypokinesia, Malaise, Vision blurred

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: Abstains from alcohol; Cholesterol normal; Non-smoker; Varicose veins
Preexisting Conditions: Comments: No known drug allergies and had a watch on eating. Family history of varicose veins, thrombosis and blood clots. Patient is healthy and exercise regularly.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210428391

Write-up: BLURRY VISION; WEAKNESS; FELT SICK; TIRED; COULDN''T MOVE; DIZZY; This spontaneous report received from a patient concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcoholic, non-smoker, no cholesterol, and varicose veins, and other pre-existing medical conditions included no known drug allergies and had a watch on eating. family history of varicose veins, thrombosis and blood clots. patient is healthy and exercise regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, and expiry: UNKNOWN) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAR-2021, the subject experienced couldn''t move. On 16-MAR-2021, the subject experienced dizzy. On 16-MAR-2021, the subject experienced felt sick. On 16-MAR-2021, the subject experienced tired. On 18-MAR-2021, the subject experienced blurry vision. On 18-MAR-2021, the subject experienced weakness. Treatment medications (dates unspecified) included: ascorbic acid/ergocalciferol/folic acid/nicotinamide/panthenol/retinol/riboflavin/thiamine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from couldn''t move, felt sick, and tired, had not recovered from dizzy, and the outcome of blurry vision and weakness was not reported. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1236234 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Wisconsin
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Dizziness, Fatigue, Hypokinesia, Malaise, Vision blurred

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: Abstains from alcohol; Cholesterol normal; Non-smoker; Varicose veins
Preexisting Conditions: Comments: No known drug allergies and had a watch on eating. Family history of varicose veins, thrombosis and blood clots. Patient is healthy and exercise regularly.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210428391

Write-up: BLURRY VISION; WEAKNESS; FELT SICK; TIRED; COULDN''T MOVE; DIZZY; This spontaneous report received from a patient concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcoholic, non-smoker, no cholesterol, and varicose veins, and other pre-existing medical conditions included no known drug allergies and had a watch on eating. family history of varicose veins, thrombosis and blood clots. patient is healthy and exercise regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, and expiry: UNKNOWN) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAR-2021, the subject experienced couldn''t move. On 16-MAR-2021, the subject experienced dizzy. On 16-MAR-2021, the subject experienced felt sick. On 16-MAR-2021, the subject experienced tired. On 18-MAR-2021, the subject experienced blurry vision. On 18-MAR-2021, the subject experienced weakness. Treatment medications (dates unspecified) included: ascorbic acid/ergocalciferol/folic acid/nicotinamide/panthenol/retinol/riboflavin/thiamine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from couldn''t move, felt sick, and tired, had not recovered from dizzy, and the outcome of blurry vision and weakness was not reported. This report was non-serious.

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