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This is VAERS ID 1327706

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1327706
VAERS Form:2
Age:62.0
Sex:Male
Location:New Jersey
Vaccinated:2021-05-08
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Interchange of vaccine products

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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: PATIENT RECEIVED A JOHNSON AND JOHNSON VACCINE BY PHARMACY ON 5/8/21. WHEN ENTERING INFORMATION INTO THE WEBSITE, WE NOTICED THAT THE PATIENT HAD ALREADY RECEIVED A PFIZER DOSE ON 3/6/21 FROM ANOTHER SITE. WHEN WE BROUGHT THIS UP TO THE PATIENT, HE DENIED EVER RECEIVING ANY OTHER VACCINE.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1327706&WAYBACKHISTORY=ON


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