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This is VAERS ID 1237132

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1237132
VAERS Form:2
Age:50.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abdominal pain, Pain in extremity

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unnknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: unknown Follow up phone call on 04/20/21 patient reported going to urgent care facility and reports receiving no treatment despite lingering symptoms.
CDC 'Split Type':

Write-up: Pt phoned our office on 04/19/21 with complaints of abdominal pain and bilateral leg pain. Pt was instructed to seek immediate health care for evaluation. He refused. Pt was very agitated and concerned about covering costs of medical care despite having health care insurance. Pt again instructed to seek health care and he refused.


Changed on 5/7/2021

VAERS ID: 1237132 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abdominal pain, Pain in extremity

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unnknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none none
Diagnostic Lab Data: unknown Follow up phone call on 04/20/21 patient reported going to urgent care facility and reports receiving no treatment despite lingering symptoms.
CDC 'Split Type':

Write-up: Pt phoned our office on 04/19/21 with complaints of abdominal pain and bilateral leg pain. Pt was instructed to seek immediate health care for evaluation. He refused. Pt was very agitated and concerned about covering costs of medical care despite having health care insurance. Pt again instructed to seek health care and he refused.


Changed on 5/14/2021

VAERS ID: 1237132 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abdominal pain, Pain in extremity

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unnknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none none
Diagnostic Lab Data: unknown Follow up phone call on 04/20/21 patient reported going to urgent care facility and reports receiving no treatment despite lingering symptoms.
CDC 'Split Type':

Write-up: Pt phoned our office on 04/19/21 with complaints of abdominal pain and bilateral leg pain. Pt was instructed to seek immediate health care for evaluation. He refused. Pt was very agitated and concerned about covering costs of medical care despite having health care insurance. Pt again instructed to seek health care and he refused.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1237132&WAYBACKHISTORY=ON


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