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This is VAERS ID 1427384

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1427384
VAERS Form:2
Age:56.0
Sex:Male
Location:Nebraska
Vaccinated:2021-06-21
Onset:2021-06-21
Submitted:0000-00-00
Entered:2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dysgeusia, Heart rate increased, Rash erythematous, Swollen tongue, Tinnitus, Vision blurred

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...10 MG...1 DAILY, FLUOXETINE...20 MG...1...DAILY, PANTOPRAZOLE...4 MG...DAILY, METFORMIN...500 MG TWICE DAILY, TESTOSTERONE... 1 ML...WEEKLY
Current Illness: NONE
Preexisting Conditions: TYPE 2 DIABETIC
Allergies: BEE STING ALLERGIES
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SWELLING OF TOUNGE, HIGH HEART RATE, BLURRED VISION, RINGING IN EARS, METAL TAISTE IN MOUTH, RED RASH ON HEAD AND CHEST. WAS TREATED AT THE EMERGENCY ROOM AND RELEASED.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1427384&WAYBACKHISTORY=ON

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