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This is VAERS ID 1133284

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1133284
VAERS Form:2
Age:50.0
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 - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dry mouth, Nausea

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: Flu vaccine, employee allergic to eggs, must have egg free vaccine
Other Medications: BP pressure medication ( Employee can not remember name of medication) Symbicort Allergic medication (Employee can''t remember the name of the medication)
Current Illness: none
Preexisting Conditions: asthma, HTN
Allergies: Eggs, seafood, dairy, shell fish, iodine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Dizziness, nausea, dry mouth all within two hours of receiving vaccine

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