National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1257873

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1257873
VAERS Form:2
Age:46.0
Sex:Female
Location:Indiana
Vaccinated:2021-04-11
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cerebrovascular accident, Glycosylated haemoglobin normal, Headache, Influenza like illness, Intensive care, Immediate post-injection reaction

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa Allergy
Diagnostic Lab Data: Hemoglobin A1c was 5.8%: No other lab results were given with discharge paperwork.
CDC 'Split Type':

Write-up: Immediately following vaccination: Flu like symptoms. 24 Hours after vaccination: Very severe headaches started and continued. 12 Days after vaccination severe Stroke/Hospitalization/ICU


Changed on 5/7/2021

VAERS ID: 1257873 Before After
VAERS Form:2
Age:46.0
Sex:Female
Location:Indiana
Vaccinated:2021-04-11
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cerebrovascular accident, Glycosylated haemoglobin normal, Headache, Influenza like illness, Intensive care, Immediate post-injection reaction

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa Allergy Allergy
Diagnostic Lab Data: Hemoglobin A1c was 5.8%: No other lab results were given with discharge paperwork.
CDC 'Split Type':

Write-up: Immediately following vaccination: Flu like symptoms. 24 Hours after vaccination: Very severe headaches started and continued. 12 Days after vaccination severe Stroke/Hospitalization/ICU


Changed on 5/14/2021

VAERS ID: 1257873 Before After
VAERS Form:2
Age:46.0
Sex:Female
Location:Indiana
Vaccinated:2021-04-11
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Cerebrovascular accident, Glycosylated haemoglobin normal, Headache, Influenza like illness, Intensive care, Immediate post-injection reaction

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa Allergy Allergy
Diagnostic Lab Data: Hemoglobin A1c was 5.8%: No other lab results were given with discharge paperwork.
CDC 'Split Type':

Write-up: Immediately following vaccination: Flu like symptoms. 24 Hours after vaccination: Very severe headaches started and continued. 12 Days after vaccination severe Stroke/Hospitalization/ICU

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1257873&WAYBACKHISTORY=ON


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