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This is VAERS ID 1263510

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1263510
VAERS Form:2
Age:59.0
Sex:Male
Location:New Jersey
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Feeling cold, Headache, Myalgia, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. daily baby aspirin 81 mg 2. vitamin c : 1000 mg twice a day 3. vitamin d : 4000 mg iu daily 4. zinc : 50 daily 5. melatonin for insomnia (1-10mg)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Mucles pain, cold, headache


Changed on 5/7/2021

VAERS ID: 1263510 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:New Jersey
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Feeling cold, Headache, Myalgia, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. daily baby aspirin 81 mg 2. vitamin c : 1000 mg twice a day 3. vitamin d : 4000 mg iu daily 4. zinc : 50 daily 5. melatonin for insomnia (1-10mg)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Mucles pain, cold, headache


Changed on 5/14/2021

VAERS ID: 1263510 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:New Jersey
Vaccinated:2021-04-08
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Feeling cold, Headache, Myalgia, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. daily baby aspirin 81 mg 2. vitamin c : 1000 mg twice a day 3. vitamin d : 4000 mg iu daily 4. zinc : 50 daily 5. melatonin for insomnia (1-10mg)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Mucles pain, cold, headache

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1263510&WAYBACKHISTORY=ON


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