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This is VAERS ID 1184584

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1184584
VAERS Form:2
Age:54.0
Sex:Female
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Nausea, Pallor

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins, 2 presc drugs
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: nausea and pale


Changed on 5/7/2021

VAERS ID: 1184584 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Nausea, Pallor

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins, 2 presc drugs
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: nausea and pale


Changed on 5/14/2021

VAERS ID: 1184584 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Missouri
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Nausea, Pallor

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins, 2 presc drugs
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: nausea and pale

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1184584&WAYBACKHISTORY=ON


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