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This is VAERS ID 1078772

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1078772
VAERS Form:2
Age:39.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hyperventilation, Loss of consciousness, Nausea, Syncope, Tremor, Muscle tightness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Nausea-Mild, Systemic: Shakiness-Medium, Additional Details: Patient felt faint immediately upon receiving the vaccination. received instruction to sit down. upon sitting down patient passed out/fainted/ muscle contractions in both hands were observed. 911 emergency services were contacted. patient then taken into ambulance for further evaluation.


Changed on 5/7/2021

VAERS ID: 1078772 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hyperventilation, Loss of consciousness, Nausea, Syncope, Tremor, Muscle tightness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Nausea-Mild, Systemic: Shakiness-Medium, Additional Details: Patient felt faint immediately upon receiving the vaccination. received instruction to sit down. upon sitting down patient passed out/fainted/ muscle contractions in both hands were observed. 911 emergency services were contacted. patient then taken into ambulance for further evaluation.


Changed on 5/14/2021

VAERS ID: 1078772 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-03-06
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hyperventilation, Loss of consciousness, Nausea, Syncope, Tremor, Muscle tightness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Nausea-Mild, Systemic: Shakiness-Medium, Additional Details: Patient felt faint immediately upon receiving the vaccination. received instruction to sit down. upon sitting down patient passed out/fainted/ muscle contractions in both hands were observed. 911 emergency services were contacted. patient then taken into ambulance for further evaluation.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1078772&WAYBACKHISTORY=ON


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