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This is VAERS ID 1132418

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1132418
VAERS Form:2
Age:59.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Dizziness, Heart rate decreased, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: None monitored VS
CDC 'Split Type':

Write-up: Couple minutes after receiving the vaccine patient was: diaphoretic heart rate mid 30''s did drop to high 20''s, weak, diazzy. Blood pressure 149/80. Incident lasted approximately 15-20 minutes and symptoms resolved. Action took was monitor patient.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1132418&WAYBACKHISTORY=ON


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