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This is VAERS ID 1178490

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1178490
VAERS Form:2
Age:19.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-07
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hypersensitivity, Nausea, Vertigo, Oropharyngeal pain

Life Threatening? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: Lyrica, Lamictal, penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She had no history of anaphylaxis from any cause, she had no history of reactions to vaccines or components. After about 5 minutes I checked on her and she said she was feeling very dizzy. I called management for assistance and got her ice packs for neck and forehead. I took her blood pressure and it was 150/90, HR 73. We laid her down and elevated her legs. She said that she felt some pressure in her chest but she had pulled a muscle there the day before and wasn''t sure if it was related. She said the room was spinning as she continued to lay on the ground and it was not improving. Her blood pressure was taken about 5 minutes later and it was 143/85 HR 73. She said it is usually low. She had no signs of local reaction, hives, or swelling. She complained of nausea. After a few more minutes she said she was not feeling any better and was having pain in her throat and difficulty breathing. I asked her to try to take a deep breath and she was gasping for air, unable to breathe deeply. I administered epinephrine (one dose) and called 911. I rechecked blood pressure while waiting for paramedics and it was 125/80. She was taken to hospital when they arrived. Her mom arrived shortly before the ambulance and went with her. Pt never lost consciousness. Management followed up with patient this evening and patient is home and well, but the ER did classify the event as an allergic reaction.


Changed on 5/7/2021

VAERS ID: 1178490 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-07
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hypersensitivity, Nausea, Vertigo, Oropharyngeal pain

Life Threatening? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: Lyrica, Lamictal, penicillin penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She had no history of anaphylaxis from any cause, she had no history of reactions to vaccines or components. After about 5 minutes I checked on her and she said she was feeling very dizzy. I called management for assistance and got her ice packs for neck and forehead. I took her blood pressure and it was 150/90, HR 73. We laid her down and elevated her legs. She said that she felt some pressure in her chest but she had pulled a muscle there the day before and wasn''t sure if it was related. She said the room was spinning as she continued to lay on the ground and it was not improving. Her blood pressure was taken about 5 minutes later and it was 143/85 HR 73. She said it is usually low. She had no signs of local reaction, hives, or swelling. She complained of nausea. After a few more minutes she said she was not feeling any better and was having pain in her throat and difficulty breathing. I asked her to try to take a deep breath and she was gasping for air, unable to breathe deeply. I administered epinephrine (one dose) and called 911. I rechecked blood pressure while waiting for paramedics and it was 125/80. She was taken to hospital when they arrived. Her mom arrived shortly before the ambulance and went with her. Pt never lost consciousness. Management followed up with patient this evening and patient is home and well, but the ER did classify the event as an allergic reaction.


Changed on 5/14/2021

VAERS ID: 1178490 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-04-07
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hypersensitivity, Nausea, Vertigo, Oropharyngeal pain

Life Threatening? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: Lyrica, Lamictal, penicillin penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She had no history of anaphylaxis from any cause, she had no history of reactions to vaccines or components. After about 5 minutes I checked on her and she said she was feeling very dizzy. I called management for assistance and got her ice packs for neck and forehead. I took her blood pressure and it was 150/90, HR 73. We laid her down and elevated her legs. She said that she felt some pressure in her chest but she had pulled a muscle there the day before and wasn''t sure if it was related. She said the room was spinning as she continued to lay on the ground and it was not improving. Her blood pressure was taken about 5 minutes later and it was 143/85 HR 73. She said it is usually low. She had no signs of local reaction, hives, or swelling. She complained of nausea. After a few more minutes she said she was not feeling any better and was having pain in her throat and difficulty breathing. I asked her to try to take a deep breath and she was gasping for air, unable to breathe deeply. I administered epinephrine (one dose) and called 911. I rechecked blood pressure while waiting for paramedics and it was 125/80. She was taken to hospital when they arrived. Her mom arrived shortly before the ambulance and went with her. Pt never lost consciousness. Management followed up with patient this evening and patient is home and well, but the ER did classify the event as an allergic reaction.

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