National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1376628

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376628
VAERS Form:2
Age:21.0
Sex:Female
Location:Delaware
Vaccinated:2021-05-27
Onset:2021-05-28
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Influenza like illness, Nausea, Paraesthesia, Pyrexia, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient states that in the first two days after vaccination, she experienced flu-like symptoms. Her symptoms progressed and became more severe with nausea, vomiting, fever, and "sleeping legs" (numbness, tingling). Pt''s mother called pharmacy on 6/3/2021 to express concern and pharmacist advised her to take daughter to emergency department. Follow-up calls to patient have gone unanswered.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376628&WAYBACKHISTORY=ON


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