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This is VAERS ID 1442309

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1442309
VAERS Form:2
Age:61.0
Sex:Male
Location:Unknown
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 UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Diarrhoea, Pain in extremity

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 (1-2 beer at evening); Cigarette smoker
Preexisting Conditions: Comments: No known allergies and patient does not abuse drug or have illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210661488

Write-up: DIARRHEA; SORE ARM; This spontaneous report received from a patient concerned a 61 year old male. The patient''s weight was 170 pounds, and height was 68 inches. The patient''s concurrent conditions included alcohol user, and cigarette smoker, and other pre-existing medical conditions included no known allergies and patient does not abuse drug or have illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 25-JUN-2021, the subject experienced sore arm. On 26-JUN-2021, the subject experienced diarrhea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea, and sore arm. This report was non-serious.

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