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This is VAERS ID 1173338

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1173338
VAERS Form:2
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood pressure increased, Hyperhidrosis, Loss of consciousness, Pallor, Paraesthesia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT HAD TINGELING IN VACCINATED ARM, THEN HE LOST CONSCIOUSNESS BRIEFLY, BLOOD PRESSURE WAS ELEVATED BRIEFLY , SWEATING, PALE , 911 WAS CALLED AND HE WAS TAKEN VIA AMBULENCE TO ER FOR EVALUATION


Changed on 5/7/2021

VAERS ID: 1173338 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood pressure increased, Hyperhidrosis, Loss of consciousness, Pallor, Paraesthesia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT HAD TINGELING IN VACCINATED ARM, THEN HE LOST CONSCIOUSNESS BRIEFLY, BLOOD PRESSURE WAS ELEVATED BRIEFLY , SWEATING, PALE , 911 WAS CALLED AND HE WAS TAKEN VIA AMBULENCE TO ER FOR EVALUATION


Changed on 5/14/2021

VAERS ID: 1173338 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:2021-04-06
Onset:2021-04-06
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood pressure increased, Hyperhidrosis, Loss of consciousness, Pallor, Paraesthesia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT HAD TINGELING IN VACCINATED ARM, THEN HE LOST CONSCIOUSNESS BRIEFLY, BLOOD PRESSURE WAS ELEVATED BRIEFLY , SWEATING, PALE , 911 WAS CALLED AND HE WAS TAKEN VIA AMBULENCE TO ER FOR EVALUATION

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1173338&WAYBACKHISTORY=ON


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