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This is VAERS ID 1236851

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1236851
VAERS Form:2
Age:66.0
Sex:Female
Location:Florida
Vaccinated:2021-04-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Contusion

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hematoma on left popliteal area. Recommend rest and monitoring


Changed on 5/7/2021

VAERS ID: 1236851 Before After
VAERS Form:2
Age:66.0
Sex:Female
Location:Florida
Vaccinated:2021-04-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Contusion

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hematoma on left popliteal area. Recommend rest and monitoring


Changed on 5/14/2021

VAERS ID: 1236851 Before After
VAERS Form:2
Age:66.0
Sex:Female
Location:Florida
Vaccinated:2021-04-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Contusion

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hematoma on left popliteal area. Recommend rest and monitoring

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1236851&WAYBACKHISTORY=ON


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