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This is VAERS ID 1129025

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1129025
VAERS Form:2
Age:61.0
Sex:Male
Location:Florida
Vaccinated:2021-03-23
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50MG Atenolol BID , 40 MG Atorvastatin Daily, 25 MG Alogliptin Daily, 81MG baby aspirin Daily , Flecainide 100MG BID, 10 MG Lisinopril daily , 2000 units Vitamin D, Cholecalif,, Daily 12.5 MG Hydrochlorothiazide Daily , 30 MG Pioglita
Current Illness:
Preexisting Conditions: AFIB/ PSVT, Type 2 Diabetic, NHL- history,
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: rash on both arms took pictures


Changed on 5/7/2021

VAERS ID: 1129025 Before After
VAERS Form:2
Age:61.0
Sex:Male
Location:Florida
Vaccinated:2021-03-23
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50MG Atenolol BID , 40 MG Atorvastatin Daily, 25 MG Alogliptin Daily, 81MG baby aspirin Daily , Flecainide 100MG BID, 10 MG Lisinopril daily , 2000 units Vitamin D, Cholecalif,, Daily 12.5 MG Hydrochlorothiazide Daily , 30 MG Pioglita
Current Illness:
Preexisting Conditions: AFIB/ PSVT, Type 2 Diabetic, NHL- history,
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: rash on both arms took pictures

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1129025&WAYBACKHISTORY=ON


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