National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

This is VAERS ID 1083427

Case Details

VAERS ID: 1083427 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Connecticut  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chills, Dizziness, Injection site pruritus
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole, PNV
Current Illness:
Preexisting Conditions: Asthma, GERD
Allergies: Magnevist dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms of feeling of doom and injection site itching after vaccine was received. No throat swelling, urticaria, hives, no progression of symptoms. Vital signs WNL -HR-90''s, BP-140/80, 02 Sat-99%. Persistent dizzy and chills. Transported for evaluation to ER.

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166