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This is VAERS ID 1768873

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1768873
VAERS Form:2
Age:36.0
Sex:Female
Location:Texas
Vaccinated:2021-09-13
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Computerised tomogram, Echocardiogram, Electrocardiogram, Pulmonary embolism

Life Threatening? Yes
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: BIRTH CONTROL, MULTIVITAMIN, MAXALT, SAXENDA
Current Illness: NO
Preexisting Conditions: ARTHITIS
Allergies: CLOMID, PROTONIX
Diagnostic Lab Data: ECHO, EKG, CT
CDC 'Split Type':

Write-up: CHEST PAIN/ PULMONARY EMBOLISM

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