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This is VAERS ID 1184894

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1184894
VAERS Form:2
Age:39.0
Sex:Female
Location:California
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 043A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Cough, Dizziness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient reported feeling dizzy, anxious, and having a dry cough Patient had no history of COVID, syncopal episodes, or anxiety with vaccines or blood work Patient stated eating and drinking water before vaccination, patient stated symptoms improved Patient seen by medical team, vitals were stable Patient provided with water and refused medical transport and signed AMA form Patient will be driven home by sister


Changed on 5/7/2021

VAERS ID: 1184894 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:California
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 043A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Cough, Dizziness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient reported feeling dizzy, anxious, and having a dry cough Patient had no history of COVID, syncopal episodes, or anxiety with vaccines or blood work Patient stated eating and drinking water before vaccination, patient stated symptoms improved Patient seen by medical team, vitals were stable Patient provided with water and refused medical transport and signed AMA form Patient will be driven home by sister


Changed on 5/14/2021

VAERS ID: 1184894 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:California
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 043A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Cough, Dizziness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient reported feeling dizzy, anxious, and having a dry cough Patient had no history of COVID, syncopal episodes, or anxiety with vaccines or blood work Patient stated eating and drinking water before vaccination, patient stated symptoms improved Patient seen by medical team, vitals were stable Patient provided with water and refused medical transport and signed AMA form Patient will be driven home by sister

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1184894&WAYBACKHISTORY=ON


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