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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1186140



Case Details

VAERS ID: 1186140 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Asthenia
SMQs:, Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 43 yo female with a c/c of Anxiety with weakness status post vaccination. pt had no signs of allergic reaction. Pt denied any sob or difficulty breathing noted. pt states good oral intake and food intake today. pt wanted to be transported for anxiety. pt was transported to PMC for further eval.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1186140


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