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This is VAERS ID 1247432

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247432
VAERS Form:2
Age:51.0
Sex:Male
Location:Tennessee
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Petechiae

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: flu vaccine and penicillin shot
Other Medications: Lisinopril, Metoprolol Succ ER, Vit D, niacin, fish oil, multi B, Aleve, Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: petechia on arms and back


Changed on 5/7/2021

VAERS ID: 1247432 Before After
VAERS Form:2
Age:51.0
Sex:Male
Location:Tennessee
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Petechiae

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: flu vaccine and penicillin shot
Other Medications: Lisinopril, Metoprolol Succ ER, Vit D, niacin, fish oil, multi B, Aleve, Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin Penicillin
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: petechia on arms and back


Changed on 5/14/2021

VAERS ID: 1247432 Before After
VAERS Form:2
Age:51.0
Sex:Male
Location:Tennessee
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Petechiae

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: flu vaccine and penicillin shot
Other Medications: Lisinopril, Metoprolol Succ ER, Vit D, niacin, fish oil, multi B, Aleve, Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin Penicillin
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: petechia on arms and back

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