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This is VAERS ID 1299625

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1299625
VAERS Form:2
Age:67.0
Sex:Male
Location:Oregon
Vaccinated:2021-05-02
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: none
Current Illness: Currently undergoing treatment for cancer
Preexisting Conditions: memory care patient in a long term care setting
Allergies: Seasonal allergies: pollen
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient was given Janssen covid-19 vaccine on 5-2-2021, when doing Alert data entry after vaccination it was discovered that the patient had received Moderna Covid-19 Vaccine in Jan/Feb of 2021.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1299625&WAYBACKHISTORY=ON


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