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This is VAERS ID 1239073

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1239073
VAERS Form:2
Age:24.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-05
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT REPORTED TO HAVE PAIN ON RIGHT ARM


Changed on 5/7/2021

VAERS ID: 1239073 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-05
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT REPORTED TO HAVE PAIN ON RIGHT ARM


Changed on 5/14/2021

VAERS ID: 1239073 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-05
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT REPORTED TO HAVE PAIN ON RIGHT ARM

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1239073&WAYBACKHISTORY=ON


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