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This is VAERS ID 1086309

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1086309
VAERS Form:2
Age:31.0
Sex:Female
Location:Nevada
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Head injury, Loss of consciousness, Syncope

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: Patient fainted about 5 minutes after receiving the vaccine. She was in the monitoring area and fell over and hit her head on the ground. I went to her aid and monitored her until the paramedics showed up. She was unconscious for a 10-15 seconds with her eyes open before regaining consciousness. IShe was not having breathing problems or other symptoms of anaphylaxis so i did not administer an epi-pen or benadryl to her. I rolled her on her side in case she became nauseas. Then the paramedics arrived and attended to her.


Changed on 5/7/2021

VAERS ID: 1086309 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Nevada
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Head injury, Loss of consciousness, Syncope

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: Patient fainted about 5 minutes after receiving the vaccine. She was in the monitoring area and fell over and hit her head on the ground. I went to her aid and monitored her until the paramedics showed up. She was unconscious for a 10-15 seconds with her eyes open before regaining consciousness. IShe was not having breathing problems or other symptoms of anaphylaxis so i did not administer an epi-pen or benadryl to her. I rolled her on her side in case she became nauseas. Then the paramedics arrived and attended to her.


Changed on 5/14/2021

VAERS ID: 1086309 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Nevada
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Head injury, Loss of consciousness, Syncope

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: Patient fainted about 5 minutes after receiving the vaccine. She was in the monitoring area and fell over and hit her head on the ground. I went to her aid and monitored her until the paramedics showed up. She was unconscious for a 10-15 seconds with her eyes open before regaining consciousness. IShe was not having breathing problems or other symptoms of anaphylaxis so i did not administer an epi-pen or benadryl to her. I rolled her on her side in case she became nauseas. Then the paramedics arrived and attended to her.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1086309&WAYBACKHISTORY=ON


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