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This is VAERS ID 1417939

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1417939
VAERS Form:2
Age:53.0
Sex:Male
Location:Texas
Vaccinated:2021-06-15
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pain in extremity, Peripheral swelling

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: LISINOPRIL 40 MG BIKTARVY 50-200 MG TRICOR 145 MCG OMEGA 3 1000 CAPSULE ERGOCALICIFEROL 50000 IU TABLET
Current Illness: HYPERTENSION, HIGH CHOLESTEROL, HIV, VITAMIN D DIFIECIENY, ATOPIC DERMATITIS , HYPERTRIGLYCERIDEMIA, BILATERAL FOOT PAIN, BILATERAL TINEA PEDIS, SOFT TISSUE MASS, ERECTILS DYSFUCTION, OBESITY NO DIAGONOSIS ON AXIS 1
Preexisting Conditions: HIV, HYPERTENSION
Allergies: NKDA
Diagnostic Lab Data: Patient was sent to emergency room for further evaluation and treatment if needed.
CDC 'Split Type':

Write-up: Patient reported pain and swelling in left leg 5 days after receiving the Janssen vaccine. Patient was seen in clinic for symptoms and was evaluated by PCP.

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