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This is VAERS ID 1082997

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1082997
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
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 1805031 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Malaise, Pulse abnormal, Snoring, Urinary incontinence

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: pantoprazole, allopurinol, aspirin, moexipril, hctz
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately ten minutes following vaccination patient decided to check his blood pressure at the automated machine because he didn''t feel well. Patient passed out sitting at the machine and lost control of his bladder. Patient''s eyes were open and he was making snoring noises. Upon checking pulse, it was faint. Patient was breathing. Team moved patient to lying position on the floor. Pulse became more prominent and patient woke up. EMS arrived and took patient to local hospital for precautionary testing. Patient discharge home 2 hours later.


Changed on 5/7/2021

VAERS ID: 1082997 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
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 1805031 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Malaise, Pulse abnormal, Snoring, Urinary incontinence

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: pantoprazole, allopurinol, aspirin, moexipril, hctz
Current Illness:
Preexisting Conditions:
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately ten minutes following vaccination patient decided to check his blood pressure at the automated machine because he didn''t feel well. Patient passed out sitting at the machine and lost control of his bladder. Patient''s eyes were open and he was making snoring noises. Upon checking pulse, it was faint. Patient was breathing. Team moved patient to lying position on the floor. Pulse became more prominent and patient woke up. EMS arrived and took patient to local hospital for precautionary testing. Patient discharge home 2 hours later.


Changed on 5/14/2021

VAERS ID: 1082997 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
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 1805031 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Malaise, Pulse abnormal, Snoring, Urinary incontinence

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: pantoprazole, allopurinol, aspirin, moexipril, hctz
Current Illness:
Preexisting Conditions:
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately ten minutes following vaccination patient decided to check his blood pressure at the automated machine because he didn''t feel well. Patient passed out sitting at the machine and lost control of his bladder. Patient''s eyes were open and he was making snoring noises. Upon checking pulse, it was faint. Patient was breathing. Team moved patient to lying position on the floor. Pulse became more prominent and patient woke up. EMS arrived and took patient to local hospital for precautionary testing. Patient discharge home 2 hours later.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1082997&WAYBACKHISTORY=ON


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