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This is VAERS ID 1185453

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185453
VAERS Form:2
Age:25.0
Sex:Male
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 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Throat irritation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Benadryl
Current Illness: None
Preexisting Conditions: None
Allergies: Montalucas
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itchy Throat and Head, back of neck


Changed on 5/7/2021

VAERS ID: 1185453 Before After
VAERS Form:2
Age:25.0
Sex:Male
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 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Throat irritation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Benadryl
Current Illness: None
Preexisting Conditions: None
Allergies: Montalucas Montalucas
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itchy Throat and Head, back of neck


Changed on 5/14/2021

VAERS ID: 1185453 Before After
VAERS Form:2
Age:25.0
Sex:Male
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 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Throat irritation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Benadryl
Current Illness: None
Preexisting Conditions: None
Allergies: Montalucas Montalucas
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itchy Throat and Head, back of neck

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185453&WAYBACKHISTORY=ON


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