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This is VAERS ID 1185923

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185923
VAERS Form:2
Age:51.0
Sex:Female
Location:Maryland
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 A42A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC CETIRIZINE FOR ALLERGIES
Current Illness: NONE NOTED
Preexisting Conditions: NONE NOTED
Allergies: PT WAS ON ALLERGY SHOTS FOR YEARS FOR ALLERGIES TO DOGS, CATS, DUST, MITES, POLLEN (STOPPED 12 YRS AGO)
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: ITCHY SKIN OVER ENTIRE BODY. NO HIVES. NO RASH. NO THROAT SWELLING.


Changed on 5/7/2021

VAERS ID: 1185923 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Maryland
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 A42A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC CETIRIZINE FOR ALLERGIES
Current Illness: NONE NOTED
Preexisting Conditions: NONE NOTED
Allergies: PT WAS ON ALLERGY SHOTS FOR YEARS FOR ALLERGIES TO DOGS, CATS, DUST, MITES, POLLEN (STOPPED 12 YRS AGO) AGO)
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: ITCHY SKIN OVER ENTIRE BODY. NO HIVES. NO RASH. NO THROAT SWELLING.


Changed on 5/14/2021

VAERS ID: 1185923 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Maryland
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 A42A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC CETIRIZINE FOR ALLERGIES
Current Illness: NONE NOTED
Preexisting Conditions: NONE NOTED
Allergies: PT WAS ON ALLERGY SHOTS FOR YEARS FOR ALLERGIES TO DOGS, CATS, DUST, MITES, POLLEN (STOPPED 12 YRS AGO) AGO)
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: ITCHY SKIN OVER ENTIRE BODY. NO HIVES. NO RASH. NO THROAT SWELLING.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185923&WAYBACKHISTORY=ON


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