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This is VAERS ID 1261202

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1261202
VAERS Form:2
Age:61.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Raynaud's phenomenon

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: Arthritis; High cholesterol
Preexisting Conditions: Medical History/Concurrent Conditions: Raynaud''s phenomenon
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429048

Write-up: RAYNAUD''S PHENOMENON; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included raynaud''s phenomenon, and concurrent conditions included high cholesterol, and arthritis in hands. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: UNKNOWN) dose was not reported, administered on 29-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced raynaud''s phenomenon. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of raynaud''s phenomenon was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.


Changed on 5/7/2021

VAERS ID: 1261202 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Raynaud's phenomenon

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: Arthritis; High cholesterol
Preexisting Conditions: Medical History/Concurrent Conditions: Raynaud''s phenomenon
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429048

Write-up: RAYNAUD''S PHENOMENON; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included raynaud''s phenomenon, and concurrent conditions included high cholesterol, and arthritis in hands. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: UNKNOWN) dose was not reported, administered on 29-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced raynaud''s phenomenon. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of raynaud''s phenomenon was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.


Changed on 5/14/2021

VAERS ID: 1261202 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Virginia
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Raynaud's phenomenon

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: Arthritis; High cholesterol
Preexisting Conditions: Medical History/Concurrent Conditions: Raynaud''s phenomenon
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429048

Write-up: RAYNAUD''S PHENOMENON; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included raynaud''s phenomenon, and concurrent conditions included high cholesterol, and arthritis in hands. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: UNKNOWN) dose was not reported, administered on 29-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced raynaud''s phenomenon. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of raynaud''s phenomenon was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.

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