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This is VAERS ID 1354822

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1354822
VAERS Form:2
Age:19.0
Sex:Female
Location:Virginia
Vaccinated:2021-05-27
Onset:2021-05-27
Submitted:0000-00-00
Entered:2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Dizziness, Vision blurred, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DAILY MULTIVITAMIN
Current Illness: NONE REPORTED
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT WAS ADMINISTERED THE JANSSEN COVID-19 VACCINE AT 11:03AM ON 5/27/21. LESS THAN 10 MINUTES LATER, PATIENT STARTED COMPLAINING OF SEVERE ABDOMINAL CRAMPS, LIGHT HEADDEDNESS, AND BLURRY VISION. SHE RUSHED TO THE RESTROOM WHEN THE CRAMPS OCCURED, WHERE SHE VOMITED AND EXPERIENCED DIARRHEA. WHEN PATIENT CAME OUT OF THE RESTROOM AROUND 15 MINUTES LATER, SHE WAS GIVEN WATER AND A SNACK BAR TO SNACK ON. SHE REPORTED FEELING BETTER, NO NAUSEA OR STOMACH CRAMPS, BUT STILL VERY WEAK. SHE WAS ESCORTED TO HER CAR VIA MOBILITY CART, WHERE HER DAD WAS ADVISED TO TAKE PATIENT TO URGENT CARE FOR FURTHER EVALUATION AND POSSIBLE FLUID THERAPY FOR DEHYDRATION.

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