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This is VAERS ID 1081606

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1081606
VAERS Form:2
Age:60.0
Sex:Female
Location:Connecticut
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Injection site pain, Syncope, Unresponsive to stimuli

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: Site: Pain at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Fainting / Unresponsive-Medium


Changed on 5/7/2021

VAERS ID: 1081606 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Connecticut
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Injection site pain, Syncope, Unresponsive to stimuli

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: Site: Pain at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Fainting / Unresponsive-Medium


Changed on 5/14/2021

VAERS ID: 1081606 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Connecticut
Vaccinated:2021-03-07
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Injection site pain, Syncope, Unresponsive to stimuli

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: Site: Pain at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Fainting / Unresponsive-Medium

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1081606&WAYBACKHISTORY=ON


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