National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1249541

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249541
VAERS Form:2
Age:
Sex:Unknown
Location:Kentucky
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Feeling jittery, Headache, Insomnia, Pain, Pyrexia

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: Drug allergy; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210443879

Write-up: SORENESS; JITTERINESS; UNABLE TO SLEEP; FATIGUE; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 71 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy, and codeine allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced soreness. On 12-APR-2021, the subject experienced jitteriness. On 12-APR-2021, the subject experienced unable to sleep. On 12-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from jitteriness, unable to sleep, and fever on 13-APR-2021, fatigue on 14-APR-2021, and headache on 15-APR-2021, and was recovering from soreness. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1249541 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Kentucky
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Feeling jittery, Headache, Insomnia, Pain, Pyrexia

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: Drug allergy; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210443879

Write-up: SORENESS; JITTERINESS; UNABLE TO SLEEP; FATIGUE; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 71 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy, and codeine allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced soreness. On 12-APR-2021, the subject experienced jitteriness. On 12-APR-2021, the subject experienced unable to sleep. On 12-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from jitteriness, unable to sleep, and fever on 13-APR-2021, fatigue on 14-APR-2021, and headache on 15-APR-2021, and was recovering from soreness. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1249541 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Kentucky
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Feeling jittery, Headache, Insomnia, Pain, Pyrexia

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: Drug allergy; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210443879

Write-up: SORENESS; JITTERINESS; UNABLE TO SLEEP; FATIGUE; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 71 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy, and codeine allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced soreness. On 12-APR-2021, the subject experienced jitteriness. On 12-APR-2021, the subject experienced unable to sleep. On 12-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from jitteriness, unable to sleep, and fever on 13-APR-2021, fatigue on 14-APR-2021, and headache on 15-APR-2021, and was recovering from soreness. This report was non-serious.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1249541&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166