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This is VAERS ID 1185450

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185450
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
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 201A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fall, Seizure

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: Depakote, ativan, valtrex
Current Illness: "anxiety seizures"
Preexisting Conditions: N/A
Allergies: neosporin, sunscreen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with previous hx of seizure disorder started convulsing within 10 minutes of vaccination, fell to the ground and convulsed for approximately 7 minutes. Convulsions reduced significantly and patient was coherent without post-ictal state. EMS was called and she was taken to nearby hospital for further evaluation. Patient had reportedly taken ativan and depakote this morning prior to arrival.


Changed on 5/7/2021

VAERS ID: 1185450 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
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 201A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fall, Seizure

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: Depakote, ativan, valtrex
Current Illness: "anxiety seizures"
Preexisting Conditions: N/A
Allergies: neosporin, sunscreen sunscreen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with previous hx of seizure disorder started convulsing within 10 minutes of vaccination, fell to the ground and convulsed for approximately 7 minutes. Convulsions reduced significantly and patient was coherent without post-ictal state. EMS was called and she was taken to nearby hospital for further evaluation. Patient had reportedly taken ativan and depakote this morning prior to arrival.


Changed on 5/14/2021

VAERS ID: 1185450 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
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 201A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fall, Seizure

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: Depakote, ativan, valtrex
Current Illness: "anxiety seizures"
Preexisting Conditions: N/A
Allergies: neosporin, sunscreen sunscreen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with previous hx of seizure disorder started convulsing within 10 minutes of vaccination, fell to the ground and convulsed for approximately 7 minutes. Convulsions reduced significantly and patient was coherent without post-ictal state. EMS was called and she was taken to nearby hospital for further evaluation. Patient had reportedly taken ativan and depakote this morning prior to arrival.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185450&WAYBACKHISTORY=ON


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