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This is VAERS ID 1259746

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1259746
VAERS Form:2
Age:47.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Pain in extremity

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: Bisoprolol Trazadone
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lower back and left leg pain


Changed on 5/7/2021

VAERS ID: 1259746 Before After
VAERS Form:2
Age:47.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Pain in extremity

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: Bisoprolol Trazadone
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: No No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lower back and left leg pain


Changed on 5/14/2021

VAERS ID: 1259746 Before After
VAERS Form:2
Age:47.0
Sex:Male
Location:California
Vaccinated:2021-04-10
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Pain in extremity

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: Bisoprolol Trazadone
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: No No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lower back and left leg pain

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1259746&WAYBACKHISTORY=ON


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