National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/4/2021 release of VAERS data:

This is VAERS ID 1241804



Case Details

VAERS ID: 1241804 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Burning sensation, Chills, Hypersensitivity, Immediate post-injection reaction, Miliaria, Muscular weakness, Paraesthesia, Peripheral swelling, Pruritus, Pyrexia, Rash macular, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: biotin
Current Illness: sinus congestion 3 weeks prior, fully recovered at the time of
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work.
CDC Split Type:

Write-up: Immediately felt weakness in arm/hand of injection with tingling in hand. Minutes later tingling in left foot. Tingling continues to occur but less frequently. Early morning the next day (4/13) had chills and fever. Fever continued through early afternoon. On 4/19 both feet felt like they were on fire and the soles itched like crazy. Went away after an hour. Around 5:30 am red spots appeared on the bottoms of feet which were very warm. This went away. Throughout the day I had red spots on my feet and legs that would be red, warm, and some itchy that would come and go. My thighs had spots that appeared to be heat rash. At 7:30 pm areas on feet were bright red, warm and slightly swollen.Diagnosed with allergic


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1241804


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