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This is VAERS ID 1082310

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1082310
VAERS Form:2
Age:57.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public      Purchased by: ??
Symptoms: Fatigue, Rash, Swelling face, Syncope, Laboratory test normal, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate Wellbutrin XL Cyanocobalamin Ibuprofen Xiddra Zestoretic
Current Illness: None
Preexisting Conditions: Depression HTN Osteopenia
Allergies: None
Diagnostic Lab Data: Transferred to local ER following near syncopal episode at PCP following medication administration. Labs normal.
CDC 'Split Type':

Write-up: Facial swelling, Diffuse facial rash- 24 hours after vaccine administation Extreme fatigue- immediately following vaccine x2 days Evaluated by PCP and given IM Benadryl and Decadron


Changed on 5/7/2021

VAERS ID: 1082310 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public      Purchased by: ??
Symptoms: Fatigue, Rash, Swelling face, Syncope, Laboratory test normal, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate Wellbutrin XL Cyanocobalamin Ibuprofen Xiddra Zestoretic
Current Illness: None
Preexisting Conditions: Depression HTN Osteopenia
Allergies: None None
Diagnostic Lab Data: Transferred to local ER following near syncopal episode at PCP following medication administration. Labs normal.
CDC 'Split Type':

Write-up: Facial swelling, Diffuse facial rash- 24 hours after vaccine administation Extreme fatigue- immediately following vaccine x2 days Evaluated by PCP and given IM Benadryl and Decadron


Changed on 5/14/2021

VAERS ID: 1082310 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public      Purchased by: ??
Symptoms: Fatigue, Rash, Swelling face, Syncope, Laboratory test normal, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate Wellbutrin XL Cyanocobalamin Ibuprofen Xiddra Zestoretic
Current Illness: None
Preexisting Conditions: Depression HTN Osteopenia
Allergies: None None
Diagnostic Lab Data: Transferred to local ER following near syncopal episode at PCP following medication administration. Labs normal.
CDC 'Split Type':

Write-up: Facial swelling, Diffuse facial rash- 24 hours after vaccine administation Extreme fatigue- immediately following vaccine x2 days Evaluated by PCP and given IM Benadryl and Decadron

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1082310&WAYBACKHISTORY=ON


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