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This is VAERS ID 1210103

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1210103
VAERS Form:2
Age:45.0
Sex:Male
Location:Utah
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Headache, Hyperhidrosis, Nausea, Vomiting, Magnetic resonance imaging abnormal, Cerebral venous sinus thrombosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: losartan
Current Illness:
Preexisting Conditions: high blood pressure
Allergies:
Diagnostic Lab Data: MRI 4/14/21
CDC 'Split Type':

Write-up: nausea, vomiting, diaphoresis, dizziness, headaches, bilateral tranverse sinus thrombosis


Changed on 5/7/2021

VAERS ID: 1210103 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:Utah
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Headache, Hyperhidrosis, Nausea, Vomiting, Magnetic resonance imaging abnormal, Cerebral venous sinus thrombosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: losartan
Current Illness:
Preexisting Conditions: high blood pressure
Allergies:
Diagnostic Lab Data: MRI 4/14/21
CDC 'Split Type':

Write-up: nausea, vomiting, diaphoresis, dizziness, headaches, bilateral tranverse sinus thrombosis


Changed on 5/14/2021

VAERS ID: 1210103 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:Utah
Vaccinated:2021-04-07
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Headache, Hyperhidrosis, Nausea, Vomiting, Magnetic resonance imaging abnormal, Cerebral venous sinus thrombosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: losartan
Current Illness:
Preexisting Conditions: high blood pressure
Allergies:
Diagnostic Lab Data: MRI 4/14/21
CDC 'Split Type':

Write-up: nausea, vomiting, diaphoresis, dizziness, headaches, bilateral tranverse sinus thrombosis

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1210103&WAYBACKHISTORY=ON

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