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This is VAERS ID 1267998

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1267998
VAERS Form:2
Age:48.0
Sex:Female
Location:Georgia
Vaccinated:2021-04-09
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Headache

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports a debilitating headache which started roughly 2 weeks after vaccine administration. We advised the patient to let her primary care provider know as soon as possible.


Changed on 5/7/2021

VAERS ID: 1267998 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Georgia
Vaccinated:2021-04-09
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Headache

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports a debilitating headache which started roughly 2 weeks after vaccine administration. We advised the patient to let her primary care provider know as soon as possible.


Changed on 5/14/2021

VAERS ID: 1267998 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Georgia
Vaccinated:2021-04-09
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Headache

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reports a debilitating headache which started roughly 2 weeks after vaccine administration. We advised the patient to let her primary care provider know as soon as possible.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1267998&WAYBACKHISTORY=ON


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