National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1185909

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1185909
VAERS Form:2
Age:39.0
Sex:Female
Location:Unknown
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 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure, Syncope

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:
Current Illness: NO
Preexisting Conditions: NO
Allergies: PCN
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT FAINTED AND HAD A 20SEC SEIZURE SEVERAL MINUTES AFTER RECIEVING VACCINE. PATIENT HAD EXTREME ANXIETY ABOUT BEING VACCINATED BEFORE HAND AS WELL AS HAD NOT EATEN DAY OF. PATIENT SYMPTOMS SUBSIDED AND HSOPITLIZATION WAS NOT REQUIRED.


Changed on 5/7/2021

VAERS ID: 1185909 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Unknown
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 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure, Syncope

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:
Current Illness: NO
Preexisting Conditions: NO
Allergies: PCN PCN
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT FAINTED AND HAD A 20SEC SEIZURE SEVERAL MINUTES AFTER RECIEVING VACCINE. PATIENT HAD EXTREME ANXIETY ABOUT BEING VACCINATED BEFORE HAND AS WELL AS HAD NOT EATEN DAY OF. PATIENT SYMPTOMS SUBSIDED AND HSOPITLIZATION WAS NOT REQUIRED.


Changed on 5/14/2021

VAERS ID: 1185909 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Unknown
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 042A21A / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure, Syncope

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:
Current Illness: NO
Preexisting Conditions: NO
Allergies: PCN PCN
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT FAINTED AND HAD A 20SEC SEIZURE SEVERAL MINUTES AFTER RECIEVING VACCINE. PATIENT HAD EXTREME ANXIETY ABOUT BEING VACCINATED BEFORE HAND AS WELL AS HAD NOT EATEN DAY OF. PATIENT SYMPTOMS SUBSIDED AND HSOPITLIZATION WAS NOT REQUIRED.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1185909&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166