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This is VAERS ID 1257650

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1257650
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
Vaccinated:2021-04-10
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mouth ulceration

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: Sertraline Hydroxyzine Esomeprazole Vitamin D Loratidine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: First mouth ulcer developed after two days, healed in about 6 days, and then developed a different ulcer and the cycle has repeated through the date of this report.


Changed on 5/7/2021

VAERS ID: 1257650 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
Vaccinated:2021-04-10
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mouth ulceration

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: Sertraline Hydroxyzine Esomeprazole Vitamin D Loratidine
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: First mouth ulcer developed after two days, healed in about 6 days, and then developed a different ulcer and the cycle has repeated through the date of this report.


Changed on 5/14/2021

VAERS ID: 1257650 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
Vaccinated:2021-04-10
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mouth ulceration

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: Sertraline Hydroxyzine Esomeprazole Vitamin D Loratidine
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: First mouth ulcer developed after two days, healed in about 6 days, and then developed a different ulcer and the cycle has repeated through the date of this report.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1257650&WAYBACKHISTORY=ON


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