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This is VAERS ID 1365948

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365948
VAERS Form:2
Age:22.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, 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)? No
Hospitalized? No
Previous Vaccinations: same reaction
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: anxiety
Allergies: na/a
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Shortly after vaccination within 5 mins pt was sitting on floor. She stated she wanted trash can and shortly after vomited. She stated dizzy too. BP was not low, and no other SS were noted.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1365948&WAYBACKHISTORY=ON


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