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This is VAERS ID 1242758

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1242758
VAERS Form:2
Age:35.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Chest pain, Cough, Diarrhoea, Dyspnoea, Myalgia, Pyrexia, Vomiting, SARS-CoV-2 test positive

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies: No known allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt received first and only dose of Janssen J&J COVID vaccine on 4/5/2021. 2 weeks later, patient would have been considered to reach full immunity. On 4/21/2021, pt went to the ED with symptoms of COVID and tested positive via SARS-CoV-2 PCR. Pt was not ill enough to be admitted. "Symptoms include nonproductive cough, pleuritic chest pain, shortness of breath, arthralgias, myalgias, fever, vomiting, diarrhea."


Changed on 5/7/2021

VAERS ID: 1242758 Before After
VAERS Form:2
Age:35.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Chest pain, Cough, Diarrhoea, Dyspnoea, Myalgia, Pyrexia, Vomiting, SARS-CoV-2 test positive

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies: No known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt received first and only dose of Janssen J&J COVID vaccine on 4/5/2021. 2 weeks later, patient would have been considered to reach full immunity. On 4/21/2021, pt went to the ED with symptoms of COVID and tested positive via SARS-CoV-2 PCR. Pt was not ill enough to be admitted. "Symptoms include nonproductive cough, pleuritic chest pain, shortness of breath, arthralgias, myalgias, fever, vomiting, diarrhea."


Changed on 5/14/2021

VAERS ID: 1242758 Before After
VAERS Form:2
Age:35.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Chest pain, Cough, Diarrhoea, Dyspnoea, Myalgia, Pyrexia, Vomiting, SARS-CoV-2 test positive

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies: No known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt received first and only dose of Janssen J&J COVID vaccine on 4/5/2021. 2 weeks later, patient would have been considered to reach full immunity. On 4/21/2021, pt went to the ED with symptoms of COVID and tested positive via SARS-CoV-2 PCR. Pt was not ill enough to be admitted. "Symptoms include nonproductive cough, pleuritic chest pain, shortness of breath, arthralgias, myalgias, fever, vomiting, diarrhea."

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1242758&WAYBACKHISTORY=ON


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