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This is VAERS ID 1242643

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1242643
VAERS Form:2
Age:61.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chills, Pain, Pyrexia, Adverse reaction

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: Vitamins: D, C. Calcium, turmeric, and collagen.
Current Illness: no
Preexisting Conditions: osteoporosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 24 hours after vaccine - fever, chills, and aches. Currently (4/21/21) having chest pains. Doctor appointment this afternoon. He suggested I fill out the adverse reaction page.


Changed on 5/7/2021

VAERS ID: 1242643 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chills, Pain, Pyrexia, Adverse reaction

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: Vitamins: D, C. Calcium, turmeric, and collagen.
Current Illness: no
Preexisting Conditions: osteoporosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 24 hours after vaccine - fever, chills, and aches. Currently (4/21/21) having chest pains. Doctor appointment this afternoon. He suggested I fill out the adverse reaction page.


Changed on 5/14/2021

VAERS ID: 1242643 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Chills, Pain, Pyrexia, Adverse reaction

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: Vitamins: D, C. Calcium, turmeric, and collagen.
Current Illness: no
Preexisting Conditions: osteoporosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 24 hours after vaccine - fever, chills, and aches. Currently (4/21/21) having chest pains. Doctor appointment this afternoon. He suggested I fill out the adverse reaction page.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1242643&WAYBACKHISTORY=ON


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