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This is VAERS ID 1378179

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1378179
VAERS Form:2
Age:59.0
Sex:Male
Location:Texas
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Throat tightness

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: "Janssen COVID-19 Vaccine EUA About 7 minutes after the patient received Janssen covid-19 vaccine, he started complaining about his throat feeling tight and difficulty breathing. I quickly give him one dose of epinephrine 0.3mg on the right thigh and about five minutes later he recovered. I requested to call 911 but the patient declined. I asked him to wait longer but he left .

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1378179&WAYBACKHISTORY=ON


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