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This is VAERS ID 1180803

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1180803
VAERS Form:2
Age:38.0
Sex:Female
Location:Puerto Rico
Vaccinated:2021-03-27
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling hot, Pruritus

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: Unknown
Preexisting Conditions: None
Allergies: Aspirin
Diagnostic Lab Data: No test or laboratories performed.
CDC 'Split Type':

Write-up: After 15 minutes from receiving the vaccine, patient complained of pruritus at her face and warm sensation at her upper extremeties, oral mucosa was within normal limits. Patient denied chest pain, shortness of breaths, palpitations, nor was sweating, no rash nor skin or mucosal lesions. She was calm able to talk incomplete sentences. Only remarkable previous history of allergy to Aspirin. Patient was send to ER and ER Physician Assessment was pruritus . She was treated at ER with Methylprednisolone and Diphenydramine IV; symptoms resolved. Discharged home with hydroxyzine as needed for itchiness.


Changed on 5/7/2021

VAERS ID: 1180803 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Puerto Rico
Vaccinated:2021-03-27
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling hot, Pruritus

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: Unknown
Preexisting Conditions: None
Allergies: Aspirin Aspirin
Diagnostic Lab Data: No test or laboratories performed.
CDC 'Split Type':

Write-up: After 15 minutes from receiving the vaccine, patient complained of pruritus at her face and warm sensation at her upper extremeties, oral mucosa was within normal limits. Patient denied chest pain, shortness of breaths, palpitations, nor was sweating, no rash nor skin or mucosal lesions. She was calm able to talk incomplete sentences. Only remarkable previous history of allergy to Aspirin. Patient was send to ER and ER Physician Assessment was pruritus . She was treated at ER with Methylprednisolone and Diphenydramine IV; symptoms resolved. Discharged home with hydroxyzine as needed for itchiness.


Changed on 5/14/2021

VAERS ID: 1180803 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Puerto Rico
Vaccinated:2021-03-27
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling hot, Pruritus

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: Unknown
Preexisting Conditions: None
Allergies: Aspirin Aspirin
Diagnostic Lab Data: No test or laboratories performed.
CDC 'Split Type':

Write-up: After 15 minutes from receiving the vaccine, patient complained of pruritus at her face and warm sensation at her upper extremeties, oral mucosa was within normal limits. Patient denied chest pain, shortness of breaths, palpitations, nor was sweating, no rash nor skin or mucosal lesions. She was calm able to talk incomplete sentences. Only remarkable previous history of allergy to Aspirin. Patient was send to ER and ER Physician Assessment was pruritus . She was treated at ER with Methylprednisolone and Diphenydramine IV; symptoms resolved. Discharged home with hydroxyzine as needed for itchiness.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1180803&WAYBACKHISTORY=ON

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