National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1770411

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1770411
VAERS Form:2
Age:
Sex:Female
Location:Florida
Vaccinated:0000-00-00
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211421A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Pyrexia, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Test Date: 20211004; Test Name: Body temperature; Result Unstructured Data: 99.9 F; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Name: COVID-19 virus test; Result Unstructured Data: Negative.
CDC 'Split Type': USJNJFOC20211011905

Write-up: This spontaneous report received from a patient concerned a female of unspecified age. 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, and batch number: 211421A expiry: UNKNOWN) dose was not reported, administered on 21-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-OCT-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.9 F. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) Negative, Negative, Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 06-OCT-2021. This report was non-serious.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1770411&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166