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This is VAERS ID 1147830

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1147830
VAERS Form:2
Age:31.0
Sex:Male
Location:California
Vaccinated:2021-03-30
Onset:2021-03-30
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1805025 / N/A LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Condition aggravated, Fall, Loss of consciousness, Seizure

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: N/A
Current Illness: N/A
Preexisting Conditions: Hx of. Seizure
Allergies: N/A
Diagnostic Lab Data: N/a
CDC 'Split Type':

Write-up: At approximately 1238 patient was noted to be on floor, experienced fall from chair. 911 called. came to patient. Pt placed in recumbent position. noted to be having seizure regained consciousness. Airway not obstructed no s/s if respiratory destress noted. Regain consciousness after 2 seconds. Vs bp130/82, O298% on RA, HR 72, RR 28. Denies pain or discomfort. Pt alert and oriented able to state his name date location. Mae x34 l neurologically intact. did not give Epi . No s/s of anaphylaxis noted. please patient and become a position. Ambulance and fire department on site at this time.

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