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This is VAERS ID 1173350

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1173350
VAERS Form:2
Age:35.0
Sex:Unknown
Location:Florida
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: Urticaria

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
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Patient was in to have Janssen vaccination at 12:30pm . She waited her appropriate time and felt fine. At 4:50 pm she developed a reaction of hives on the torso, legs and arms. She said she could not take the benadryl because it would be lock up her throat as has happed before. She tried to contact md office, but they were closed and we suggested she go to ER and she proceeded to go to the ER.


Changed on 5/7/2021

VAERS ID: 1173350 Before After
VAERS Form:2
Age:35.0
Sex:Unknown
Location:Florida
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: Urticaria

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
Preexisting Conditions: unknown
Allergies: unknown unknown
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Patient was in to have Janssen vaccination at 12:30pm . She waited her appropriate time and felt fine. At 4:50 pm she developed a reaction of hives on the torso, legs and arms. She said she could not take the benadryl because it would be lock up her throat as has happed before. She tried to contact md office, but they were closed and we suggested she go to ER and she proceeded to go to the ER.


Changed on 5/14/2021

VAERS ID: 1173350 Before After
VAERS Form:2
Age:35.0
Sex:Unknown
Location:Florida
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: Urticaria

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
Preexisting Conditions: unknown
Allergies: unknown unknown
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Patient was in to have Janssen vaccination at 12:30pm . She waited her appropriate time and felt fine. At 4:50 pm she developed a reaction of hives on the torso, legs and arms. She said she could not take the benadryl because it would be lock up her throat as has happed before. She tried to contact md office, but they were closed and we suggested she go to ER and she proceeded to go to the ER.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1173350&WAYBACKHISTORY=ON

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