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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||207A21A / UNK||AR / IM|
Administered by: Senior Living Purchased by: ??
Symptoms: Cough, Dyspnoea, Heart rate increased, Malaise, Pneumonia, Respiratory rate increased
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1
Write-up: Patient did not feel well after receiving vaccination. Indicated that she developed a cough, shortness of breath and increased respirations and pulse. She admitted to the hospital on 6/8/21 and was diagnosed with pneumonia.
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21525 Ridgetop Circle, Suite 100, Sterling, VA 20166