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This is VAERS ID 1249408

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249408
VAERS Form:2
Age:56.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Polymerase chain reaction, Taste disorder, Suspected COVID-19

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: PCR; Result Unstructured Data: Negative (unit unspecified)
CDC 'Split Type': USJNJFOC20210438020

Write-up: COVID SYMPTOMS; CHILLS; NAUSEA; TASTE SENSATION; LIGHTHEADEDNESS; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: PCR (NR: not provided) Negative (unit unspecified). On 11-APR-2021, the subject experienced taste sensation. On 11-APR-2021, the subject experienced lightheadedness. On 11-APR-2021, the subject experienced chills. On 11-APR-2021, the subject experienced nausea. On 19-APR-2021, the subject experienced covid symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from taste sensation, and chills, was recovering from lightheadedness, and covid symptoms, and had not recovered from nausea. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1249408 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Polymerase chain reaction, Taste disorder, Suspected COVID-19

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: PCR; Result Unstructured Data: Negative (unit unspecified)
CDC 'Split Type': USJNJFOC20210438020

Write-up: COVID SYMPTOMS; CHILLS; NAUSEA; TASTE SENSATION; LIGHTHEADEDNESS; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: PCR (NR: not provided) Negative (unit unspecified). On 11-APR-2021, the subject experienced taste sensation. On 11-APR-2021, the subject experienced lightheadedness. On 11-APR-2021, the subject experienced chills. On 11-APR-2021, the subject experienced nausea. On 19-APR-2021, the subject experienced covid symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from taste sensation, and chills, was recovering from lightheadedness, and covid symptoms, and had not recovered from nausea. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1249408 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Polymerase chain reaction, Taste disorder, Suspected COVID-19

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: PCR; Result Unstructured Data: Negative (unit unspecified)
CDC 'Split Type': USJNJFOC20210438020

Write-up: COVID SYMPTOMS; CHILLS; NAUSEA; TASTE SENSATION; LIGHTHEADEDNESS; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: PCR (NR: not provided) Negative (unit unspecified). On 11-APR-2021, the subject experienced taste sensation. On 11-APR-2021, the subject experienced lightheadedness. On 11-APR-2021, the subject experienced chills. On 11-APR-2021, the subject experienced nausea. On 19-APR-2021, the subject experienced covid symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from taste sensation, and chills, was recovering from lightheadedness, and covid symptoms, and had not recovered from nausea. This report was non-serious.

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