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This is VAERS ID 1237265

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1237265
VAERS Form:2
Age:71.0
Sex:Female
Location:Washington
Vaccinated:2021-03-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Headache, Lethargy

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: Slight hives with Penecillin 60 years ago.
Other Medications: Hydro chlorothiazide Atorvastatin
Current Illness: None
Preexisting Conditions: None other than a heart murmur
Allergies: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe chills and lethargy on Monday - slept all day. Moderate chills and slight headache on right rear in the morning on Tuesday. A little lasting lethargy today.


Changed on 5/7/2021

VAERS ID: 1237265 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Washington
Vaccinated:2021-03-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Headache, Lethargy

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: Slight hives with Penecillin 60 years ago.
Other Medications: Hydro chlorothiazide Atorvastatin
Current Illness: None
Preexisting Conditions: None other than a heart murmur
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe chills and lethargy on Monday - slept all day. Moderate chills and slight headache on right rear in the morning on Tuesday. A little lasting lethargy today.


Changed on 5/14/2021

VAERS ID: 1237265 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Washington
Vaccinated:2021-03-13
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Headache, Lethargy

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: Slight hives with Penecillin 60 years ago.
Other Medications: Hydro chlorothiazide Atorvastatin
Current Illness: None
Preexisting Conditions: None other than a heart murmur
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe chills and lethargy on Monday - slept all day. Moderate chills and slight headache on right rear in the morning on Tuesday. A little lasting lethargy today.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1237265&WAYBACKHISTORY=ON


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