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This is VAERS ID 1091261

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1091261
VAERS Form:2
Age:47.0
Sex:Female
Location:Florida
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea, Influenza like illness

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: n/a
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: sever flu like symptoms. Then chest tightening and inability to breathe. Spouse called 911.


Changed on 5/7/2021

VAERS ID: 1091261 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Florida
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea, Influenza like illness

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: n/a
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a n/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: sever flu like symptoms. Then chest tightening and inability to breathe. Spouse called 911.


Changed on 5/14/2021

VAERS ID: 1091261 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Florida
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea, Influenza like illness

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: n/a
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a n/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: sever flu like symptoms. Then chest tightening and inability to breathe. Spouse called 911.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1091261&WAYBACKHISTORY=ON


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