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This is VAERS ID 1346719

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1346719
VAERS Form:2
Age:88.0
Sex:Female
Location:New Jersey
Vaccinated:2021-05-20
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Blood pressure increased, Computerised tomogram normal, Facial paralysis, Headache

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg daily acetaminophen as needed betamethasone valerate lotion carvedilol 12.5 mg daily cholecalciferol 1000 units daily docusate 200mg daily ferrous sulfate 325mg daily glimepiride 2mg daily levemir 6 units daily melatonin 3
Current Illness:
Preexisting Conditions: psoriasis anemia constipation type 2 Diabetes Mellitus CAD A fib COPD CHF
Allergies: codeine dexlansoprazole erythromycin penicillin demerol robitussin-DM Zemuron Zithromax
Diagnostic Lab Data: CT scan negative on 5/22/21
CDC 'Split Type':

Write-up: headache elevated blood pressure left eye drooping

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1346719&WAYBACKHISTORY=ON


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