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This is VAERS ID 1367696

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367696
VAERS Form:2
Age:31.0
Sex:Male
Location:Michigan
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: School      Purchased by: ??
Symptoms: Injection site haemorrhage, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown/not reported
Allergies: denies
Diagnostic Lab Data: na
CDC 'Split Type':

Write-up: near immediate lump at injection site. minimal bleeding when withdrawing needed. lump measured at injection site 18 mm x 13 mm. no active bleeding, no erythema or bruising. Spoke to patient for 8 minutes during which time no additional signs or symptoms were noted. Discussed next steps. Will call to check on status in 4-5 hours and again in 20-24 hours. Advised to contact our clinic or PCP with any additional questions or concerns. Has appt with PCP 6/3/21 for annual PE. Advised to monitor site periodically.

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