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This is VAERS ID 1247954

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247954
VAERS Form:2
Age:54.0
Sex:Female
Location:Idaho
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Erythema, Hypersensitivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Had a mild allergic reaction, face turned red under the eyes and on the nose and cheeks within about 10 minutes after receiving vaccination. Administered 50mg diphenhydramine orally. Symptoms remained the same for about 20 minutes then started lessening. After about 45 minutes from time of administration of vaccine symptoms were nearly resolved and patient was allowed to go home with instructions to call 911 or the pharmacy if symptoms returned and difficulty breathing occurred. No further response from patient.


Changed on 5/7/2021

VAERS ID: 1247954 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Idaho
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Erythema, Hypersensitivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Had a mild allergic reaction, face turned red under the eyes and on the nose and cheeks within about 10 minutes after receiving vaccination. Administered 50mg diphenhydramine orally. Symptoms remained the same for about 20 minutes then started lessening. After about 45 minutes from time of administration of vaccine symptoms were nearly resolved and patient was allowed to go home with instructions to call 911 or the pharmacy if symptoms returned and difficulty breathing occurred. No further response from patient.


Changed on 5/14/2021

VAERS ID: 1247954 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Idaho
Vaccinated:2021-04-12
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Erythema, Hypersensitivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Had a mild allergic reaction, face turned red under the eyes and on the nose and cheeks within about 10 minutes after receiving vaccination. Administered 50mg diphenhydramine orally. Symptoms remained the same for about 20 minutes then started lessening. After about 45 minutes from time of administration of vaccine symptoms were nearly resolved and patient was allowed to go home with instructions to call 911 or the pharmacy if symptoms returned and difficulty breathing occurred. No further response from patient.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247954&WAYBACKHISTORY=ON


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