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This is VAERS ID 1384333

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1384333
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2021-06-06
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Eye pain, Headache

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210613084

Write-up: EYE PAIN; SEVERE HEADACHE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 05-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-JUN-2021, the subject experienced eye pain. On 06-JUN-2021, the subject experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headache, and eye pain. This report was non-serious.

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