National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1083427

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1083427
VAERS Form:2
Age:38.0
Sex:Female
Location:Connecticut
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 1805022 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Anxiety, Chills, Dizziness, Injection site pruritus

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: 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.


Changed on 5/7/2021

VAERS ID: 1083427 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Connecticut
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 1805022 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Anxiety, Chills, Dizziness, Injection site pruritus

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: Pantoprazole, PNV
Current Illness:
Preexisting Conditions: Asthma, GERD
Allergies: Magnevist dye 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.


Changed on 5/14/2021

VAERS ID: 1083427 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Connecticut
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 1805022 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Anxiety, Chills, Dizziness, Injection site pruritus

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: Pantoprazole, PNV
Current Illness:
Preexisting Conditions: Asthma, GERD
Allergies: Magnevist dye 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:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1083427&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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