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This is VAERS ID 1185485

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185485
VAERS Form:2
Age:20.0
Sex:Male
Location:Washington
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 202A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Presyncope

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Possible old reaction to shell fish
Diagnostic Lab Data: BP intially 88/P in Trendelenberg position, second BP 110/P, 3rd BP in seated position 114/P
CDC 'Split Type':

Write-up: dizzy, light-headed, near syncope


Changed on 5/7/2021

VAERS ID: 1185485 Before After
VAERS Form:2
Age:20.0
Sex:Male
Location:Washington
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 202A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Presyncope

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Possible old reaction to shell fish fish
Diagnostic Lab Data: BP intially 88/P in Trendelenberg position, second BP 110/P, 3rd BP in seated position 114/P
CDC 'Split Type':

Write-up: dizzy, light-headed, near syncope


Changed on 5/14/2021

VAERS ID: 1185485 Before After
VAERS Form:2
Age:20.0
Sex:Male
Location:Washington
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 202A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Presyncope

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Possible old reaction to shell fish fish
Diagnostic Lab Data: BP intially 88/P in Trendelenberg position, second BP 110/P, 3rd BP in seated position 114/P
CDC 'Split Type':

Write-up: dizzy, light-headed, near syncope

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