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This is VAERS ID 1172442

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1172442
VAERS Form:2
Age:60.0
Sex:Female
Location:Texas
Vaccinated:2021-03-11
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1B02072 / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Rash, Streptococcus test, SARS-CoV-2 test

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: Goli
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: strep test and COVID test
CDC 'Split Type':

Write-up: Rash over most of the trunk area, head and neck.


Changed on 5/7/2021

VAERS ID: 1172442 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Texas
Vaccinated:2021-03-11
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1B02072 / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Rash, Streptococcus test, SARS-CoV-2 test

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: Goli
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: strep test and COVID test
CDC 'Split Type':

Write-up: Rash over most of the trunk area, head and neck.


Changed on 5/14/2021

VAERS ID: 1172442 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Texas
Vaccinated:2021-03-11
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1B02072 / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Rash, Streptococcus test, SARS-CoV-2 test

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: Goli
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: strep test and COVID test
CDC 'Split Type':

Write-up: Rash over most of the trunk area, head and neck.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1172442&WAYBACKHISTORY=ON

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