National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1133185

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1133185
VAERS Form:2
Age:32.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-25
Onset:2021-03-25
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: Pruritus, Swelling of eyelid, Periorbital swelling

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:
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.


Changed on 5/7/2021

VAERS ID: 1133185 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-25
Onset:2021-03-25
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: Pruritus, Swelling of eyelid, Periorbital swelling

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:
Current Illness:
Preexisting Conditions:
Allergies: N/a 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.

New Search

Link To This Search Result:

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


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