National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1373266

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1373266
VAERS Form:2
Age:35.0
Sex:Male
Location:Minnesota
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LC1820095 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Headache, Pain in extremity, Pyrexia

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: Alcoholic (Every Fridays- one to two beers.); Non-smoker
Preexisting Conditions: Comments: The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210604811

Write-up: ACHY LEGS; CHILLS; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 35 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcoholic, and non smoker, and other pre-existing medical conditions included the patient did not have any history of drug abuse or illicit drug use. The patient experienced drug allergy when treated with guaifenesin for hyperactivity. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: LC1820095 expiry: 04-JUL-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced achy legs. On 02-JUN-2021, the subject experienced chills. On 02-JUN-2021, the subject experienced fever. The action taken with covid-19 vaccine was not applicable. The patient recovered from chills on 02-JUN-2021, and had not recovered from headache, fever, and achy legs. This report was non-serious.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1373266&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166