National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1269172

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1269172
VAERS Form:2
Age:39.0
Sex:Female
Location:New Jersey
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Rash, Peripheral swelling, Contusion

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: Contact dermatitis; Eczema; Comments: The patient had No known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210452477

Write-up: SWELLING OF LEGS; BRUISING OF LEG; RASH ON LEGS; This spontaneous report received from a consumer concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included contact dermatitis, and eczema, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021, the subject experienced bruising of leg. On 19-APR-2021, the subject experienced rash on legs. On 24-APR-2021, the subject experienced swelling of legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on legs, swelling of legs, and bruising of leg. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1269172 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:New Jersey
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Rash, Peripheral swelling, Contusion

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: Contact dermatitis; Eczema; Comments: The patient had No known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210452477

Write-up: SWELLING OF LEGS; BRUISING OF LEG; RASH ON LEGS; This spontaneous report received from a consumer concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included contact dermatitis, and eczema, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021, the subject experienced bruising of leg. On 19-APR-2021, the subject experienced rash on legs. On 24-APR-2021, the subject experienced swelling of legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on legs, swelling of legs, and bruising of leg. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1269172 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:New Jersey
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Rash, Peripheral swelling, Contusion

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: Contact dermatitis; Eczema; Comments: The patient had No known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210452477

Write-up: SWELLING OF LEGS; BRUISING OF LEG; RASH ON LEGS; This spontaneous report received from a consumer concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included contact dermatitis, and eczema, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021, the subject experienced bruising of leg. On 19-APR-2021, the subject experienced rash on legs. On 24-APR-2021, the subject experienced swelling of legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on legs, swelling of legs, and bruising of leg. This report was non-serious.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1269172&WAYBACKHISTORY=ON


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