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This is VAERS ID 1134845

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1134845
VAERS Form:2
Age:30.0
Sex:Female
Location:Tennessee
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 1808609 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Erythema, Fall, Feeling hot, Headache, Hyperhidrosis, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received vaccine while seated and had no problems. She stood up and walked several feet to the observation seating area and had a seat. A few minutes later she fainted and fell out of the chair onto the floor. We helped her up to a sitting position and gave her a bottle of water and an ice pack. The right side of her forehead appeared red from apparent hit on the floor when she fainted. We had her wait on the floor for about 30 minutes to ensure she remained conscious. Patient reported an ache on her forehead at site of hit. She was also sweating and reported feeling hot. Patient had a partner with her who agreed to escort her to an urgent care clinic in the same building as the pharmacy. Store manager in charge took the patient to the urgent care clinic by wheelchair to be examined.


Changed on 5/7/2021

VAERS ID: 1134845 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Tennessee
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 1808609 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Erythema, Fall, Feeling hot, Headache, Hyperhidrosis, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received vaccine while seated and had no problems. She stood up and walked several feet to the observation seating area and had a seat. A few minutes later she fainted and fell out of the chair onto the floor. We helped her up to a sitting position and gave her a bottle of water and an ice pack. The right side of her forehead appeared red from apparent hit on the floor when she fainted. We had her wait on the floor for about 30 minutes to ensure she remained conscious. Patient reported an ache on her forehead at site of hit. She was also sweating and reported feeling hot. Patient had a partner with her who agreed to escort her to an urgent care clinic in the same building as the pharmacy. Store manager in charge took the patient to the urgent care clinic by wheelchair to be examined.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1134845&WAYBACKHISTORY=ON


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