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This is VAERS ID 1079411

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1079411
VAERS Form:2
Age:50.0
Sex:Female
Location:Mississippi
Vaccinated:2021-03-04
Onset:2021-03-04
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Palpitations, Swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xysel 50 mg PO daily
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC 'Split Type': MR0252021

Write-up: Individual responded to waiting parking lot. Patient c/o sensation of facial swelling and heart racing. Denied other complaints. 1500 B/P 110/80. HR 140 Resp 12. 1503 Pt states she felt heart rate slowing down. No further feeling of swelling in face, throat, or elsewhere. 1505 HR 128. 1510 Patient talking and breathing without difficulty. Advised to seek medical attention if s/s worsen. 3/5/2021 @ 1040 employee f/u with patient with phone call. Patient reported that after leaving the site, she felt HR increasing. Went to ED and was monitored for two hours. Systolic pressure there was 161. HR was in 140s. No interventions by ED after monitor. States is fine today.


Changed on 5/7/2021

VAERS ID: 1079411 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Mississippi
Vaccinated:2021-03-04
Onset:2021-03-04
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Palpitations, Swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xysel 50 mg PO daily
Current Illness:
Preexisting Conditions:
Allergies: Sulfa Sulfa
Diagnostic Lab Data:
CDC 'Split Type': MR0252021

Write-up: Individual responded to waiting parking lot. Patient c/o sensation of facial swelling and heart racing. Denied other complaints. 1500 B/P 110/80. HR 140 Resp 12. 1503 Pt states she felt heart rate slowing down. No further feeling of swelling in face, throat, or elsewhere. 1505 HR 128. 1510 Patient talking and breathing without difficulty. Advised to seek medical attention if s/s worsen. 3/5/2021 @ 1040 employee f/u with patient with phone call. Patient reported that after leaving the site, she felt HR increasing. Went to ED and was monitored for two hours. Systolic pressure there was 161. HR was in 140s. No interventions by ED after monitor. States is fine today.


Changed on 5/14/2021

VAERS ID: 1079411 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Mississippi
Vaccinated:2021-03-04
Onset:2021-03-04
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Palpitations, Swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xysel 50 mg PO daily
Current Illness:
Preexisting Conditions:
Allergies: Sulfa Sulfa
Diagnostic Lab Data:
CDC 'Split Type': MR0252021

Write-up: Individual responded to waiting parking lot. Patient c/o sensation of facial swelling and heart racing. Denied other complaints. 1500 B/P 110/80. HR 140 Resp 12. 1503 Pt states she felt heart rate slowing down. No further feeling of swelling in face, throat, or elsewhere. 1505 HR 128. 1510 Patient talking and breathing without difficulty. Advised to seek medical attention if s/s worsen. 3/5/2021 @ 1040 employee f/u with patient with phone call. Patient reported that after leaving the site, she felt HR increasing. Went to ED and was monitored for two hours. Systolic pressure there was 161. HR was in 140s. No interventions by ED after monitor. States is fine today.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1079411&WAYBACKHISTORY=ON


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