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This is VAERS ID 1136116

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1136116
VAERS Form:2
Age:60.0
Sex:Female
Location:Tennessee
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 1808609 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dysphagia, Throat irritation, Oral pruritus, Paraesthesia oral, Blood pressure measurement, Pharyngeal paraesthesia

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: unknown
Current Illness: unknown. none that we were aware of
Preexisting Conditions: unknown
Allergies: prednisone
Diagnostic Lab Data: Has a history of a severe reaction to prednisone. upon inquiring, patient stated it caused insomnia for about a year and was unable to work. No history of any sort of anaphylactic reaction.
CDC 'Split Type':

Write-up: Within a minute of receiving the vaccine, pt reported itchy/tingly sensation in her mouth and throat. Initially stated she could breathe/swallow just fine but very quickly stated the swallowing was getting more difficult. 911 was called followed by 0.3 mg EpiPen in her right outer thigh and 50mg of oral Benadryl. Her BP was then taken around 4:45 and it was 162/93 at which point EMT arrived and took over.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1136116&WAYBACKHISTORY=ON


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