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This is VAERS ID 1092339

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1092339
VAERS Form:2
Age:51.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-11
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 AR / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Loss of consciousness, Nausea, Nervousness, Pallor, 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: None
Current Illness: Patient had not eaten all day due to travel.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After getting vaccinated and escorted to waiting area patient fainted out of chair and hit head on floor. She was briefly unconscious and pale for a few minutes after coming back to consciousness. She remained on the floor feeling dizzy, shaky, and nauseous until she was taken to the hospital by paramedics.


Changed on 5/7/2021

VAERS ID: 1092339 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-11
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 AR / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Loss of consciousness, Nausea, Nervousness, Pallor, 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: None
Current Illness: Patient had not eaten all day due to travel.
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After getting vaccinated and escorted to waiting area patient fainted out of chair and hit head on floor. She was briefly unconscious and pale for a few minutes after coming back to consciousness. She remained on the floor feeling dizzy, shaky, and nauseous until she was taken to the hospital by paramedics.


Changed on 5/14/2021

VAERS ID: 1092339 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-11
Submitted:0000-00-00
Entered:2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 AR / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Loss of consciousness, Nausea, Nervousness, Pallor, 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: None
Current Illness: Patient had not eaten all day due to travel.
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After getting vaccinated and escorted to waiting area patient fainted out of chair and hit head on floor. She was briefly unconscious and pale for a few minutes after coming back to consciousness. She remained on the floor feeling dizzy, shaky, and nauseous until she was taken to the hospital by paramedics.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1092339&WAYBACKHISTORY=ON


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