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From the 4/30/2021 release of VAERS data:

This is VAERS ID 1133185



Case Details

VAERS ID: 1133185 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085029 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Periorbital swelling, Pruritus, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies: N/a
Diagnostic Lab Data: Employee was escorted to Emergency Room for further evaluation. States that she was given steroid injection and then prescribed oral steroid taper pack.
CDC Split Type:

Write-up: Approximately 15 minutes after receiving dose of vaccine, employee states that she began to itch all over. Eyelids and periorbital area began to swell. She did not experience any shortness of breath or difficulty swallowing.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1133185


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