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This is VAERS ID 1387348

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1387348
VAERS Form:2
Age:42.0
Sex:Male
Location:Texas
Vaccinated:2021-05-06
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Headache, Vaccination site pain, Vaccination 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Currently presents a bruise with pain when touched in the area where the vaccine was placed. A little headache in the temple area.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1387348&WAYBACKHISTORY=ON


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