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This is VAERS ID 1454796

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454796
VAERS Form:2
Age:16.0
Sex:Male
Location:Kentucky
Vaccinated:2021-07-07
Onset:2021-07-07
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immunization was given to a 16 year old

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454796&WAYBACKHISTORY=ON

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