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This is VAERS ID 1337716

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1337716
VAERS Form:2
Age:16.0
Sex:Female
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 1816025 / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, Product administered to patient of inappropriate age

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: patient received Janssen vaccine and was under age 18. Patient did well no issues post vaccination

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1337716&WAYBACKHISTORY=ON


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