National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1262665

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1262665
VAERS Form:2
Age:43.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram, Headache, Pain, Pain in extremity, Pelvic pain, Ultrasound scan, Limb discomfort, Blood test

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: Daily multivitamin
Current Illness: Between 7 hours and 14 hours after having vaccine on 4/5/21, I had severe chills, severe headache, internal sharp pain in my pelvis (right and left side).
Preexisting Conditions: None
Allergies: Levofloxacin (Levaquin)
Diagnostic Lab Data: Wed 4/14/21 - Sought medical attention at ED. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache.
CDC 'Split Type':

Write-up: Mon 4/12/21 - Headaches started and have continued daily. Tue 4/13/21 - Soreness in right calf muscle, continued for 4 days. Headache continued. Wed 4/14/21 - Sharp pain in pelvis (right and left side) same location I experienced pain the day of receiving vaccine. Occasionally felt this pain 2 or 3 times / day for 2 days. Sought medical attention at ED on the advice of our Nurse Call Center. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache. Thu 4/15/21 - Shooting pain in random parts of my body, mostly legs and arms. Experienced throughout this day only. As of 4/27/21, 22 days after being vaccinated, I am still experiencing headaches. More noticeable when I am exerting myself - walking outside for 1-2 minutes triggers the headache. Headaches are usually located in the lower back of my head. Before being vaccinated, I would experience less than 1 headache per month, and they go away within the day.


Changed on 5/7/2021

VAERS ID: 1262665 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram, Headache, Pain, Pain in extremity, Pelvic pain, Ultrasound scan, Limb discomfort, Blood test

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: Daily multivitamin
Current Illness: Between 7 hours and 14 hours after having vaccine on 4/5/21, I had severe chills, severe headache, internal sharp pain in my pelvis (right and left side).
Preexisting Conditions: None
Allergies: Levofloxacin (Levaquin) (Levaquin)
Diagnostic Lab Data: Wed 4/14/21 - Sought medical attention at ED. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache.
CDC 'Split Type':

Write-up: Mon 4/12/21 - Headaches started and have continued daily. Tue 4/13/21 - Soreness in right calf muscle, continued for 4 days. Headache continued. Wed 4/14/21 - Sharp pain in pelvis (right and left side) same location I experienced pain the day of receiving vaccine. Occasionally felt this pain 2 or 3 times / day for 2 days. Sought medical attention at ED on the advice of our Nurse Call Center. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache. Thu 4/15/21 - Shooting pain in random parts of my body, mostly legs and arms. Experienced throughout this day only. As of 4/27/21, 22 days after being vaccinated, I am still experiencing headaches. More noticeable when I am exerting myself - walking outside for 1-2 minutes triggers the headache. Headaches are usually located in the lower back of my head. Before being vaccinated, I would experience less than 1 headache per month, and they go away within the day.


Changed on 5/14/2021

VAERS ID: 1262665 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-04-05
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram, Headache, Pain, Pain in extremity, Pelvic pain, Ultrasound scan, Limb discomfort, Blood test

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: Daily multivitamin
Current Illness: Between 7 hours and 14 hours after having vaccine on 4/5/21, I had severe chills, severe headache, internal sharp pain in my pelvis (right and left side).
Preexisting Conditions: None
Allergies: Levofloxacin (Levaquin) (Levaquin)
Diagnostic Lab Data: Wed 4/14/21 - Sought medical attention at ED. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache.
CDC 'Split Type':

Write-up: Mon 4/12/21 - Headaches started and have continued daily. Tue 4/13/21 - Soreness in right calf muscle, continued for 4 days. Headache continued. Wed 4/14/21 - Sharp pain in pelvis (right and left side) same location I experienced pain the day of receiving vaccine. Occasionally felt this pain 2 or 3 times / day for 2 days. Sought medical attention at ED on the advice of our Nurse Call Center. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache. Thu 4/15/21 - Shooting pain in random parts of my body, mostly legs and arms. Experienced throughout this day only. As of 4/27/21, 22 days after being vaccinated, I am still experiencing headaches. More noticeable when I am exerting myself - walking outside for 1-2 minutes triggers the headache. Headaches are usually located in the lower back of my head. Before being vaccinated, I would experience less than 1 headache per month, and they go away within the day.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1262665&WAYBACKHISTORY=ON


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