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This is VAERS ID 1439576

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1439576
VAERS Form:2
Age:54.0
Sex:Male
Location:New Mexico
Vaccinated:0000-00-00
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Abdominal pain upper, Body temperature, 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: Abstains from alcohol; Blood pressure high (Patient Takes medication.); Hormone replacement therapy; Non-smoker
Preexisting Conditions: Comments: Patient had No known allergies any allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210629; Test Name: Body temperature; Result Unstructured Data: 99.6 F
CDC 'Split Type': USJNJFOC20210666560

Write-up: SHARP PAIN IN STOMACH; LOW GRADE FEVER; This spontaneous report received from a consumer concerned a 54 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcoholic, non smoker, high blood pressure, and testosterone replacement, and other pre-existing medical conditions included patient had no known allergies any allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808986, and expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUN-2021, the subject experienced sharp pain in stomach. On 29-JUN-2021, the subject experienced low grade fever. Laboratory data included: Body temperature (NR: not provided) 99.6 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from low grade fever, and had not recovered from sharp pain in stomach. This report was non-serious.

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