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This is VAERS ID 1465379

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1465379
VAERS Form:2
Age:39.0
Sex:Female
Location:Washington
Vaccinated:2021-06-15
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Herpes zoster, Rash vesicular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine 75ug, Vitamin B Complex
Current Illness:
Preexisting Conditions: Hypothyroid
Allergies: Latex
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA Moderate case of shingles, left flank. Vesicular rash appeared July 1, visited urgent care to confirm and was treated with antivirals.

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