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This is VAERS ID 1181249

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1181249
VAERS Form:2
Age:41.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Vomiting, SARS-CoV-2 test negative

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: See medical record.
Current Illness: None. Chronic migraines which she received botox for on 4/6.
Preexisting Conditions: See medical record.
Allergies: See medical record.
Diagnostic Lab Data: POCT BG that was wnl. Monitoring.
CDC 'Split Type':

Write-up: Within 10 min of receiving the vaccine, patient began feeling lightheaded, vomited after being given juice by staff.


Changed on 5/7/2021

VAERS ID: 1181249 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Vomiting, SARS-CoV-2 test negative

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: See medical record.
Current Illness: None. Chronic migraines which she received botox for on 4/6.
Preexisting Conditions: See medical record.
Allergies: See medical record. record.
Diagnostic Lab Data: POCT BG that was wnl. Monitoring.
CDC 'Split Type':

Write-up: Within 10 min of receiving the vaccine, patient began feeling lightheaded, vomited after being given juice by staff.


Changed on 5/14/2021

VAERS ID: 1181249 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-08
Onset:2021-04-08
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Vomiting, SARS-CoV-2 test negative

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: See medical record.
Current Illness: None. Chronic migraines which she received botox for on 4/6.
Preexisting Conditions: See medical record.
Allergies: See medical record. record.
Diagnostic Lab Data: POCT BG that was wnl. Monitoring.
CDC 'Split Type':

Write-up: Within 10 min of receiving the vaccine, patient began feeling lightheaded, vomited after being given juice by staff.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1181249&WAYBACKHISTORY=ON

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