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This is VAERS ID 1138289

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1138289
VAERS Form:2
Age:41.0
Sex:Male
Location:Maryland
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Throat irritation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient reported known allergy to shellfish. Following injection, patient reported throat felt itchy but had no other symptoms. Pulse ox indicated 98. Patient was given liquid Benadryl 25 cc/10ml. Patient went home and had recovered at time of departure from facility.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1138289&WAYBACKHISTORY=ON


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