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This is VAERS ID 1454147

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454147
VAERS Form:2
Age:72.0
Sex:Female
Location:Unknown
Vaccinated:2021-06-25
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Urticaria, Contusion

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Hypothyroidism, ARF, CAD
Allergies: Simvastatin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left arm bruising. Patient had hives prior to ED admission that resolved at home. Received Benadryl and Tylenol.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454147&WAYBACKHISTORY=ON


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