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This is VAERS ID 1247859

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247859
VAERS Form:2
Age:66.0
Sex:Male
Location:Minnesota
Vaccinated:2021-03-04
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, SARS-CoV-2 test positive, Exposure to SARS-CoV-2

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Janssen vaccine on 3/4/21. Tested positive for COVID-19 by PCR on 4/21/21. Onset date 4/18/21 w/ cough. Known exposure to COVID-19.


Changed on 5/7/2021

VAERS ID: 1247859 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Minnesota
Vaccinated:2021-03-04
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, SARS-CoV-2 test positive, Exposure to SARS-CoV-2

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Janssen vaccine on 3/4/21. Tested positive for COVID-19 by PCR on 4/21/21. Onset date 4/18/21 w/ cough. Known exposure to COVID-19.


Changed on 5/14/2021

VAERS ID: 1247859 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Minnesota
Vaccinated:2021-03-04
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cough, SARS-CoV-2 test positive, Exposure to SARS-CoV-2

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Janssen vaccine on 3/4/21. Tested positive for COVID-19 by PCR on 4/21/21. Onset date 4/18/21 w/ cough. Known exposure to COVID-19.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247859&WAYBACKHISTORY=ON


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