National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1133570

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1133570
VAERS Form:2
Age:62.0
Sex:Female
Location:Texas
Vaccinated:2021-03-14
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Rash erythematous, Skin warm

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: sertraline 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: Lortab
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Day 11 .. right arm .. red splotchy rash, hot to the touch "Covid Arm" No prior symptoms other than sore arm.


Changed on 5/7/2021

VAERS ID: 1133570 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:Texas
Vaccinated:2021-03-14
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Rash erythematous, Skin warm

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: sertraline 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: Lortab Lortab
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Day 11 .. right arm .. red splotchy rash, hot to the touch "Covid Arm" No prior symptoms other than sore arm.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1133570&WAYBACKHISTORY=ON


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