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This is VAERS ID 1188040

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1188040
VAERS Form:2
Age:78.0
Sex:Female
Location:Oregon
Vaccinated:2021-03-10
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Cerebral haemorrhage, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodone, Namenda, HCTZ, proair, symbicort, estradiol, tylenol, xarelto, duloxetine, metoprolol, Vit D, oxycodone, gabapentin, sotalol, pramipexole, dicyclomine
Current Illness:
Preexisting Conditions: Neuropathy, Edema, Dementia, HF, AFID, HTN
Allergies: Penicillin and Streptomycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: nontraumatic subcortical hemorrhage of left cerebral hemisphere resulting in death


Changed on 5/7/2021

VAERS ID: 1188040 Before After
VAERS Form:2
Age:78.0
Sex:Female
Location:Oregon
Vaccinated:2021-03-10
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Cerebral haemorrhage, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodone, Namenda, HCTZ, proair, symbicort, estradiol, tylenol, xarelto, duloxetine, metoprolol, Vit D, oxycodone, gabapentin, sotalol, pramipexole, dicyclomine
Current Illness:
Preexisting Conditions: Neuropathy, Edema, Dementia, HF, AFID, HTN
Allergies: Penicillin and Streptomycin Streptomycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: nontraumatic subcortical hemorrhage of left cerebral hemisphere resulting in death


Changed on 5/14/2021

VAERS ID: 1188040 Before After
VAERS Form:2
Age:78.0
Sex:Female
Location:Oregon
Vaccinated:2021-03-10
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Cerebral haemorrhage, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodone, Namenda, HCTZ, proair, symbicort, estradiol, tylenol, xarelto, duloxetine, metoprolol, Vit D, oxycodone, gabapentin, sotalol, pramipexole, dicyclomine
Current Illness:
Preexisting Conditions: Neuropathy, Edema, Dementia, HF, AFID, HTN
Allergies: Penicillin and Streptomycin Streptomycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: nontraumatic subcortical hemorrhage of left cerebral hemisphere resulting in death

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1188040&WAYBACKHISTORY=ON


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