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This is VAERS ID 1185350

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185350
VAERS Form:2
Age:44.0
Sex:Male
Location:Kansas
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness

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: After receiving Janssen covid19 vaccine, patient was asked to wait for 15 minutes in the pharmacy. After 5 minutes he came back to the counter and said he does not feel well. Before we could walk around the counter, he started to collapse
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient collapsed at the counter, he was helped to the ground, he was asked to lie flat for 10 minutes. After 10 minutes he was able to sit up and he felt a lot better. After 30 minutes he was fine.


Changed on 5/7/2021

VAERS ID: 1185350 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Kansas
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness

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: After receiving Janssen covid19 vaccine, patient was asked to wait for 15 minutes in the pharmacy. After 5 minutes he came back to the counter and said he does not feel well. Before we could walk around the counter, he started to collapse
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient collapsed at the counter, he was helped to the ground, he was asked to lie flat for 10 minutes. After 10 minutes he was able to sit up and he felt a lot better. After 30 minutes he was fine.


Changed on 5/14/2021

VAERS ID: 1185350 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Kansas
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness

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: After receiving Janssen covid19 vaccine, patient was asked to wait for 15 minutes in the pharmacy. After 5 minutes he came back to the counter and said he does not feel well. Before we could walk around the counter, he started to collapse
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient collapsed at the counter, he was helped to the ground, he was asked to lie flat for 10 minutes. After 10 minutes he was able to sit up and he felt a lot better. After 30 minutes he was fine.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185350&WAYBACKHISTORY=ON


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