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This is VAERS ID 1337461

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1337461
VAERS Form:2
Age:74.0
Sex:Male
Location:North Carolina
Vaccinated:2021-05-04
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Differential white blood cell count, Full blood count, Petechiae, Blood smear test

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: APAP 650mg PO Q4-6H PRN, Imbruvica 420mg PO QD, losartan 100mg PO QD, melatonin 10mg PO QHS, tamsulosin 0.4mg PO QPM,
Current Illness: UTI
Preexisting Conditions: Anemia, hereditary motor/sensory neuropathy, non-Hodgkins''s lymphoma, obstructive and reflux uropathy, OSA, enlarged prostate with LUTS, prediabetes, hypertension,
Allergies: Adhesive tape
Diagnostic Lab Data: CBC w/diff and peripheral blood smear, pending
CDC 'Split Type':

Write-up: Pt developed petechiae on BLEs the same day he was given the vaccine (5/4/2021) and the petechiae started to improve 3-4 days later. No other adverse symptoms reported.

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