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This is VAERS ID 1071786

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1071786
VAERS Form:2
Age:64.0
Sex:Female
Location:Colorado
Vaccinated:2021-03-03
Onset:2021-03-03
Submitted:0000-00-00
Entered:2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Chills, Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg Vitamin b Calcium
Current Illness: none
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Fever (100) and chills all night, headache, and painful injection site.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1071786&WAYBACKHISTORY=ON


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