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This is VAERS ID 1088460

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1088460
VAERS Form:2
Age:26.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Injury, Posture abnormal, Syncope, Unresponsive to stimuli

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: Fainting / Unresponsive-Severe, Additional Details: Patient remembered sitting down in a chair for observation, then slumped forward while on his phone. He did not remember falling over and was alert and oriented right away. Emergency services were called as he sustained an injury during his fall.


Changed on 5/7/2021

VAERS ID: 1088460 Before After
VAERS Form:2
Age:26.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Injury, Posture abnormal, Syncope, Unresponsive to stimuli

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: Fainting / Unresponsive-Severe, Additional Details: Patient remembered sitting down in a chair for observation, then slumped forward while on his phone. He did not remember falling over and was alert and oriented right away. Emergency services were called as he sustained an injury during his fall.


Changed on 5/14/2021

VAERS ID: 1088460 Before After
VAERS Form:2
Age:26.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-09
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Injury, Posture abnormal, Syncope, Unresponsive to stimuli

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: Fainting / Unresponsive-Severe, Additional Details: Patient remembered sitting down in a chair for observation, then slumped forward while on his phone. He did not remember falling over and was alert and oriented right away. Emergency services were called as he sustained an injury during his fall.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1088460&WAYBACKHISTORY=ON


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