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This is VAERS ID 1322581

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1322581
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Illness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210526182

Write-up: SICK; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 02-MAY-2021 for prophylactic vaccination.The batch number was not reported. Per procedure, no follow-up will be requested for this case.No concomitant medications were reported. On 02-MAY-2021, the subject experienced sick. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sick on 08-MAY-2021. This report was non-serious. This case, from the same reporter is linked to 20210527035.

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