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This is VAERS ID 1377959

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1377959
VAERS Form:2
Age:40.0
Sex:Female
Location:Florida
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Paraesthesia, Pyrexia, Skin discolouration, Contusion

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: unknown
Current Illness: back surgery 3 weeks prior
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: The husband came to pharmacy to receive his COVID vaccine and informed us of his wife experiencing a possible adverse reaction from her Janssen COVID shot. He said the patient experienced fever of 101 and tingling/sharp prickling of the face the night of the vaccine and the following morning. She took an unknown fever reducer with success. The following day her legs began looking dark and bruised and she was numb and tingling in the legs. As of today (the next day), the bruising (dark color) has reduced and she only has slight numbness and tingling in the legs. He said she had back surgery 3 weeks ago so is unsure of the cause. We informed him that she should be taken to a doctor as soon as possible to rule out the possibility of blood clotting. He acknowledged and said they will discuss immediately when he gets home and either take her to the ER or keep a close eye on her and take her to PCP on Monday morning.

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