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This is VAERS ID 1328257

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328257
VAERS Form:2
Age:18.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Rash

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: WIthin 5 minutes of patient receiving J&J covid vaccine, she started to develop a large rash on her arm that was quickly spreading. Patient stated that it was not itchy but hurt. I gave her Children''s Allergy Relief 12.5mg/5ml and gave her 10ml. Within 5 minutes the rash was starting to subside already. Patient was kept an additional 5 minutes and felt fine when she left.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328257&WAYBACKHISTORY=ON


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