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This is VAERS ID 1247036

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247036
VAERS Form:2
Age:40.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-21
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diverticulitis, Computerised tomogram abdomen

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
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: CT of abdomen confirmed acute diverticulitis
CDC 'Split Type':

Write-up: Patient had acute diverticulitis within 3 weeks of J and J vaccine


Changed on 5/7/2021

VAERS ID: 1247036 Before After
VAERS Form:2
Age:40.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-21
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diverticulitis, Computerised tomogram abdomen

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
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: CT of abdomen confirmed acute diverticulitis
CDC 'Split Type':

Write-up: Patient had acute diverticulitis within 3 weeks of J and J vaccine


Changed on 5/14/2021

VAERS ID: 1247036 Before After
VAERS Form:2
Age:40.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-21
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Diverticulitis, Computerised tomogram abdomen

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
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: CT of abdomen confirmed acute diverticulitis
CDC 'Split Type':

Write-up: Patient had acute diverticulitis within 3 weeks of J and J vaccine

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247036&WAYBACKHISTORY=ON


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