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This is VAERS ID 1368768

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368768
VAERS Form:2
Age:43.0
Sex:Male
Location:Texas
Vaccinated:2021-05-31
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Headache, Oedema peripheral

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: NSAIDS Aspirin
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient reported received his Johnson and Johnson COVID 19 vaccine 05/31/2021. Reported stated having generalized joint aches, HA and left axillary swelling. Reported symptoms stated 06/1/2021 at 8pm. patient reported did not take any medications for symptoms.

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