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This is VAERS ID 1442301

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1442301
VAERS Form:2
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Headache, Nasopharyngitis, Pain, 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: Allergic reaction to antibiotics (Some antibiotics cause sensitivity but patient did not list which ones.); Food allergy (patient stated some antibiotics causes sensitivity but did not list which ones); Head cold; Migraine headache (patient sometimes gets migraines after eating certain foods, and had a little bit of a headache after eating one of those foods last week.)
Preexisting Conditions: Medical History/Concurrent Conditions: Hyperthyroidism
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Body temperature; Result Unstructured Data: 99 F; Comments: fever was 99 degrees Farenheit
CDC 'Split Type': USJNJFOC20210660901

Write-up: BODY ACHES; DULL HEADACHE; FEVER; HEAD CONGESTION WORSENED; This spontaneous report received from a patient concerned a 55 year old female. The patient''s weight was 147 pounds, and height was 67 inches. The patient''s past medical history included hyperthyroidism, and concurrent conditions included allergic to chocolate and caffeine, head congestion, migraines, and allergic to some antibiotics. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced body aches. On 25-JUN-2021, the subject experienced dull headache. On 25-JUN-2021, the subject experienced fever. On 25-JUN-2021, the subject experienced head congestion worsened. Laboratory data included: Body temperature (NR: not provided) 99 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches, dull headache, fever, and head congestion worsened. This report was non-serious.

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