Adverse Event Reporting

VAERS ID	1074773
Gender	Female
Age	65
StateCode	MA
Pharmaceutical Company	JANSSEN
Lot Number
Number of vaccinations	1
Vaccinated	2021-03-04
Onset	2021-03-04
Condition	Recovered

Symptoms

• Pyrexia

Current Illness

Procedure with Botox for Adductor Spasmodic Dysponia on 1/19/21

Preexisting Conditions

Other Medications

as listed in Epic Buproprion, Multivitamen, Omega 3 100 mg, Raloxifene 60 mg, Ranitidine, Valacyclovir

Previous Vaccinations

Allergies

Fluoxetine, Erythromycin, Ibuprofen, Penicillins, Bactrim

Laboratory Data

Write-up

Pt received J/J vaccine at location yesterday (3/4/21) at 11am.
She noticed a fever at around 3pm.
She had a fever to 104-105 all during the night, she was 99 this am.