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This is VAERS ID 1129924

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1129924
VAERS Form:2
Age:22.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-03-22
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Malaise, Pallor

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: After receiving vaccine, patient complained of not feeling well and feeling faint. Patient laid on floor with feet elevated. Bp 96/58, P 70, R 18. Color was pale with no signs of respiratory distress or other skin changes noted. Given cool compress and juice. Transferred to cot to monitor for half hour. Before leaving patient noted to have pink color back to skin, was tolerating sitting without feeling dizzy, and vitals: Bp 110/80, P 88, R 16.


Changed on 5/7/2021

VAERS ID: 1129924 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-03-22
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Malaise, Pallor

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown unknown
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: After receiving vaccine, patient complained of not feeling well and feeling faint. Patient laid on floor with feet elevated. Bp 96/58, P 70, R 18. Color was pale with no signs of respiratory distress or other skin changes noted. Given cool compress and juice. Transferred to cot to monitor for half hour. Before leaving patient noted to have pink color back to skin, was tolerating sitting without feeling dizzy, and vitals: Bp 110/80, P 88, R 16.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1129924&WAYBACKHISTORY=ON


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