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This is VAERS ID 1367706

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367706
VAERS Form:2
Age:31.0
Sex:Male
Location:New York
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 206A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Underdose, Needle issue

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: albuterol, zyrtec
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: When going to inject vaccine, needle was inserted into arm and when the syringe was depressed the needle retracted immediately, sending most of the vaccine down the patients arm and leaving some in the barrel, it is believed to be less than half the dose administered therefore a second full dose of vaccine was administered in the opposite arm.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367706&WAYBACKHISTORY=ON


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