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This is VAERS ID 1442370

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1442370
VAERS Form:2
Age:55.0
Sex:Male
Location:Nevada
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Abdominal distension, Abdominal pain upper, Chills, Colonoscopy, Injection site pain

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: TESTOSTERONE
Current Illness: Hypotestosteronism (Patient had on Testosterone injections for Low T (but had not in the past month).); Non-smoker; Social alcohol drinker (occasional social consumer.)
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Colonoscopy; Result Unstructured Data: colon twisted
CDC 'Split Type': USJNJFOC20210667910

Write-up: STOMACH PAINS; CHILLS WITH FREEZING SHIVERS; PAIN WHERE VACCINE WAS INJECTED; ENTIRE STOMACH FEELS BLOATED AND GASSY; This spontaneous report received from a patient concerned a 55 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included low testosterone, alcohol use, and non smoker, and other pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 23-JUN-2021 for prophylactic vaccination. Concomitant medications included testosterone for low testosterone. On JUN-2021, the subject experienced entire stomach feels bloated and gassy. On 23-JUN-2021, the subject experienced pain where vaccine was injected. On 25-JUN-2021, the subject experienced stomach pains. On 25-JUN-2021, the subject experienced chills with freezing shivers. Laboratory data (dates unspecified) included: Colonoscopy (NR: not provided) colon twisted. Treatment medications (dates unspecified) included: simeticone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills with freezing shivers, and had not recovered from stomach pains, pain where vaccine was injected, and entire stomach feels bloated and gassy. This report was non-serious.

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