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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1233276



Case Details

VAERS ID: 1233276 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Malaise, On and off phenomenon, Pain
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (narrow), Vestibular disorders (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: claritin daily, valtrex prn, Daily multivitamin, glucosamine, vit d, vit e, vit b6, & tumeric supplements
Current Illness: NONE
Preexisting Conditions: Arthritis Myalgia Anxiety
Allergies: bactrim, emycin, protonix, citrus foods/juices
Diagnostic Lab Data:
CDC Split Type:

Write-up: -Mild to Moderate headache, mild dizziness on and off, and increased body aches for 4 days following vaccination. -Generally felt ''under the weather'' not quite myself for a full week following vaccination. Gradually starting to feel back to baseline second week post vaccine


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1233276


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