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This is VAERS ID 1082746

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1082746
VAERS Form:2
Age:44.0
Sex:Male
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram, Hyperhidrosis, Presyncope, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Vit C Tylenol
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: Peanut
Diagnostic Lab Data: Attended ER. Physical assessment Labs EKG
CDC 'Split Type':

Write-up: 10 minutes after injection, dizzy spell and vasovagal reaction. Diaphoretic, pulse rate 48, BP 107/71.


Changed on 5/7/2021

VAERS ID: 1082746 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram, Hyperhidrosis, Presyncope, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Vit C Tylenol
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: Peanut Peanut
Diagnostic Lab Data: Attended ER. Physical assessment Labs EKG
CDC 'Split Type':

Write-up: 10 minutes after injection, dizzy spell and vasovagal reaction. Diaphoretic, pulse rate 48, BP 107/71.


Changed on 5/14/2021

VAERS ID: 1082746 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Texas
Vaccinated:2021-03-08
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram, Hyperhidrosis, Presyncope, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Vit C Tylenol
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: Peanut Peanut
Diagnostic Lab Data: Attended ER. Physical assessment Labs EKG
CDC 'Split Type':

Write-up: 10 minutes after injection, dizzy spell and vasovagal reaction. Diaphoretic, pulse rate 48, BP 107/71.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1082746&WAYBACKHISTORY=ON


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