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This is VAERS ID 1081538

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1081538
VAERS Form:2
Age:51.0
Sex:Female
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest discomfort, Throat tightness

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:
CDC 'Split Type':

Write-up: Patient with previous history of sangioedema reaction to vaccine or medication received J&J COVID single dose vaccine and had throat and chest tightness. Treated by EMS, transported to hospital. The vaccine does not require a second dose. CDC recommendations are that no further action is needed at this time.


Changed on 5/7/2021

VAERS ID: 1081538 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest discomfort, Throat tightness

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:
CDC 'Split Type':

Write-up: Patient with previous history of sangioedema reaction to vaccine or medication received J&J COVID single dose vaccine and had throat and chest tightness. Treated by EMS, transported to hospital. The vaccine does not require a second dose. CDC recommendations are that no further action is needed at this time.


Changed on 5/14/2021

VAERS ID: 1081538 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest discomfort, Throat tightness

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:
CDC 'Split Type':

Write-up: Patient with previous history of sangioedema reaction to vaccine or medication received J&J COVID single dose vaccine and had throat and chest tightness. Treated by EMS, transported to hospital. The vaccine does not require a second dose. CDC recommendations are that no further action is needed at this time.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1081538&WAYBACKHISTORY=ON


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