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This is VAERS ID 1376567

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376567
VAERS Form:2
Age:34.0
Sex:Female
Location:Maryland
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abdominal pain upper, Diarrhoea, Nausea, Urticaria, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Severe stomach pain and cramps, diarrhea, nausea, vomiting, hives. The onset was approximately 4 hours after receiving the vaccine. The peak of pain was approximately 12 hours after injection. Hives remain on abdomen and thighs 48 hours later.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376567&WAYBACKHISTORY=ON


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