| Days after vaccination:||0
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN
||205A21A / 1
||LA / IM
Administered by: Private Purchased by: ?
Impaired work ability,
Laboratory test normal,
Pain in extremity,
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Permanent Disability? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Previous Vaccinations: Anaphylaxis, 64 years old, 12/29/21, Moderna Covid 19 vaccination.
Other Medications: Acyclovir, estrace cream, MSM, glucosamine, chondroitin, boron.
Current Illness: Chronic idiopathic peripheral neuropathy, chronic idiopathic urticaria, IBS.
Preexisting Conditions: See above.
Allergies: Moderna covid vaccine: anaphylactic reaction.
Diagnostic Lab Data: All negative, had neurological workup which was normal. Now waiting to see if I present with Guillia-Barre. Hope I can update this later if I do.
CDC Split Type:
Write-up: J and J vaccine: 40 min. after shot, my lower lip began to tingle, then went numb, next my upper lip, next nose felt funny. chest felt tight, no wheezing. Was still at Clinic so I went to Urgent care. I used my albuterol inhaler, chest tightness resolved. Treated in UC with solumedrol, famoditine, 1 liter NaCl. My allergist had me on 2 Zytec, and 2 famoditine the day of shot. Went to urgent care 7/5 for neuropathy. Saw neurologist on 7/8/21. Today is 12 days after the vaccination. My peripheral neuropathy is so bad I can''t work. I have constant pain in my shoulder girdle, lower back thighs, calves, feet, hands, and visceral. My PCP won''t give my any pain meds, my pain is 8/10.