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This is VAERS ID 1695737

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1695737
VAERS Form:2
Age:47.0
Sex:Unknown
Location:California
Vaccinated:2021-09-11
Onset:2021-09-11
Submitted:0000-00-00
Entered:2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JNJ201A21A / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Asthenia, Chest pain, Dizziness, Heart rate irregular

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: Seroquel 14 mg
Current Illness:
Preexisting Conditions: Lyme disease
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Dizziness, heart irregular beating , chest pain , weakness

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