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This is VAERS ID 1249462

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249462
VAERS Form:2
Age:
Sex:Female
Location:New York
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: Fatigue, Headache

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210440857

Write-up: HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight was 135 pounds, and height was 63 inches. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 14:00 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced headache. On 11-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and fatigue on 13-APR-2021. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1249462 Before After
VAERS Form:2
Age:
Sex:Female
Location:New York
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: Fatigue, Headache

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210440857

Write-up: HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight was 135 pounds, and height was 63 inches. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 14:00 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced headache. On 11-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and fatigue on 13-APR-2021. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1249462 Before After
VAERS Form:2
Age:
Sex:Female
Location:New York
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: Fatigue, Headache

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210440857

Write-up: HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight was 135 pounds, and height was 63 inches. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 14:00 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced headache. On 11-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and fatigue on 13-APR-2021. This report was non-serious.

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