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This is VAERS ID 1481245

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1481245
VAERS Form:2
Age:67.0
Sex:Male
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Headache, Muscular weakness, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC 'Split Type': USJNJFOC20210729174

Write-up: LEG GIVING OUT; HEADACHE; FEVER OF 101 F; This spontaneous report received from a patient concerned a 67 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21a, expiry: 07-AUG-2021) dose was not reported, administered on 03-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced headache. On 03-JUL-2021, the subject experienced fever of 101 f. Laboratory data included: Body temperature (NR: not provided) 101 F. On 12-JUL-2021, the subject experienced leg giving out. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from leg giving out, and the outcome of headache and fever of 101 f was not reported. This report was non-serious.

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