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This is VAERS ID 1261215

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1261215
VAERS Form:2
Age:24.0
Sex:Female
Location:Minnesota
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Intermenstrual bleeding, Muscle spasms, 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:
Preexisting Conditions: Medical History/Concurrent Conditions: IUCD; Comments: The patient did not have any medical history. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429908

Write-up: This spontaneous report received from a patient concerned a 24 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included intrauterine device (iud), and other pre-existing medical conditions included the patient did not have any medical history. the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced tired. On 12-APR-2021, the subject experienced cramps. Treatment medications included: ibuprofen. On 12-APR-2021 16:00, the subject experienced fever. On 14-APR-2021 09:00, the subject experienced vaginal bleeding. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tired on 13-APR-2021, and fever on 12-APR-2021, had not recovered from vaginal bleeding, and the outcome of cramps was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


Changed on 5/7/2021

VAERS ID: 1261215 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Minnesota
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Intermenstrual bleeding, Muscle spasms, 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:
Preexisting Conditions: Medical History/Concurrent Conditions: IUCD; Comments: The patient did not have any medical history. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429908

Write-up: This spontaneous report received from a patient concerned a 24 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included intrauterine device (iud), and other pre-existing medical conditions included the patient did not have any medical history. the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced tired. On 12-APR-2021, the subject experienced cramps. Treatment medications included: ibuprofen. On 12-APR-2021 16:00, the subject experienced fever. On 14-APR-2021 09:00, the subject experienced vaginal bleeding. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tired on 13-APR-2021, and fever on 12-APR-2021, had not recovered from vaginal bleeding, and the outcome of cramps was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


Changed on 5/14/2021

VAERS ID: 1261215 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Minnesota
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Intermenstrual bleeding, Muscle spasms, 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:
Preexisting Conditions: Medical History/Concurrent Conditions: IUCD; Comments: The patient did not have any medical history. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210429908

Write-up: This spontaneous report received from a patient concerned a 24 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included intrauterine device (iud), and other pre-existing medical conditions included the patient did not have any medical history. the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced tired. On 12-APR-2021, the subject experienced cramps. Treatment medications included: ibuprofen. On 12-APR-2021 16:00, the subject experienced fever. On 14-APR-2021 09:00, the subject experienced vaginal bleeding. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tired on 13-APR-2021, and fever on 12-APR-2021, had not recovered from vaginal bleeding, and the outcome of cramps was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.

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