National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1195158

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1195158
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-01
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Blood urea normal, Chills, Diarrhoea, Differential white blood cell count normal, Dizziness, Fatigue, Headache, Neutrophil count increased, Platelet count normal, Rash, Red blood cell count decreased, Tachycardia, Vasculitis, Lymphocyte percentage decreased, Metabolic function test

Life Threatening? Yes
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: n/a
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: CBC (04/09/21), WBC: 10.0 , RBC: 4.05 (low), PLT: 362 (high), NEUT %: 77.8 (high), LYMPH %: 14.0 (low), NEUT #: 7.79 (high), CMP (04/09/21), BUN: 19 (high)
CDC 'Split Type':

Write-up: Tachycardia, Fatigue, Dizziness, Headache, Diarrhea, Chills, Vasculitis, Face Rash.


Changed on 5/7/2021

VAERS ID: 1195158 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-01
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Blood urea normal, Chills, Diarrhoea, Differential white blood cell count normal, Dizziness, Fatigue, Headache, Neutrophil count increased, Platelet count normal, Rash, Red blood cell count decreased, Tachycardia, Vasculitis, Lymphocyte percentage decreased, Metabolic function test

Life Threatening? Yes
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: n/a
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Penicillin Penicillin
Diagnostic Lab Data: CBC (04/09/21), WBC: 10.0 , RBC: 4.05 (low), PLT: 362 (high), NEUT %: 77.8 (high), LYMPH %: 14.0 (low), NEUT #: 7.79 (high), CMP (04/09/21), BUN: 19 (high)
CDC 'Split Type':

Write-up: Tachycardia, Fatigue, Dizziness, Headache, Diarrhea, Chills, Vasculitis, Face Rash.


Changed on 5/14/2021

VAERS ID: 1195158 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-01
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Blood urea normal, Chills, Diarrhoea, Differential white blood cell count normal, Dizziness, Fatigue, Headache, Neutrophil count increased, Platelet count normal, Rash, Red blood cell count decreased, Tachycardia, Vasculitis, Lymphocyte percentage decreased, Metabolic function test

Life Threatening? Yes
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: n/a
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Penicillin Penicillin
Diagnostic Lab Data: CBC (04/09/21), WBC: 10.0 , RBC: 4.05 (low), PLT: 362 (high), NEUT %: 77.8 (high), LYMPH %: 14.0 (low), NEUT #: 7.79 (high), CMP (04/09/21), BUN: 19 (high)
CDC 'Split Type':

Write-up: Tachycardia, Fatigue, Dizziness, Headache, Diarrhea, Chills, Vasculitis, Face Rash.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1195158&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166