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This is VAERS ID 1379741

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1379741
VAERS Form:2
Age:42.0
Sex:Male
Location:New York
Vaccinated:2021-05-29
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Injection site bruising

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: I felt pain on the right side of my abdomen on June 4th. I see a bruise on the site on June 7th.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1379741&WAYBACKHISTORY=ON


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