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This is VAERS ID 1083296

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1083296
VAERS Form:2
Age:48.0
Sex:Female
Location:Nebraska
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 18005020 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dry mouth, Electrocardiogram, Headache, Muscle spasms, Pain in extremity, Palpitations, Pharyngeal swelling

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG done in the urgent care today.
CDC 'Split Type':

Write-up: started sore arm soon after, arm pain persisted, heart racing, dry mouth, sore swollen throat, severe headache, spasm in arm


Changed on 5/7/2021

VAERS ID: 1083296 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Nebraska
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 18005020 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dry mouth, Electrocardiogram, Headache, Muscle spasms, Pain in extremity, Palpitations, Pharyngeal swelling

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: EKG done in the urgent care today.
CDC 'Split Type':

Write-up: started sore arm soon after, arm pain persisted, heart racing, dry mouth, sore swollen throat, severe headache, spasm in arm


Changed on 5/14/2021

VAERS ID: 1083296 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Nebraska
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 18005020 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dry mouth, Electrocardiogram, Headache, Muscle spasms, Pain in extremity, Palpitations, Pharyngeal swelling

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: EKG done in the urgent care today.
CDC 'Split Type':

Write-up: started sore arm soon after, arm pain persisted, heart racing, dry mouth, sore swollen throat, severe headache, spasm in arm

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1083296&WAYBACKHISTORY=ON


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