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This is VAERS ID 1172954

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1172954
VAERS Form:2
Age:18.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Monoplegia, Panic reaction, Vision blurred

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: patient stated she began to develop blurry vision as well as arm soreness. began to breathe heavily due to panic and stated there was numbness going down her left leg. 911 was called and symptoms began to resolve as ambulance arrived.


Changed on 5/7/2021

VAERS ID: 1172954 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Monoplegia, Panic reaction, Vision blurred

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: patient stated she began to develop blurry vision as well as arm soreness. began to breathe heavily due to panic and stated there was numbness going down her left leg. 911 was called and symptoms began to resolve as ambulance arrived.


Changed on 5/14/2021

VAERS ID: 1172954 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Illinois
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Monoplegia, Panic reaction, Vision blurred

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: patient stated she began to develop blurry vision as well as arm soreness. began to breathe heavily due to panic and stated there was numbness going down her left leg. 911 was called and symptoms began to resolve as ambulance arrived.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1172954&WAYBACKHISTORY=ON


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