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This is VAERS ID 1470430

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1470430
VAERS Form:2
Age:52.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-06-05
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: COVID-19, SARS-CoV-2 test positive

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: SARS-CoV-2 N gene Resp Ql NAA+probe~SARS-COV-2 (COVID-19) CLINIC COLLECT KIT OR EXTERNAL KIT performed on 7/13/2021 at 11:29. Test came back positive. Based on case investigation documentation, client is asymptomatic and reports no chronic health conditions.

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