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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1186023



Case Details

VAERS ID: 1186023 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram, Consciousness fluctuating, Dyskinesia, Dyspnoea, Eye movement disorder, Hot flush, Hyperhidrosis, Hypoaesthesia oral, Seizure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Men?s one a day Glucosamine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ambulance attended to and transported to hospital. Blood test, chest X-ray, CT so far done at hospital.
CDC Split Type:

Write-up: Five minutes after shot started losing consciousness, sweating, hot flashes, trouble breathing, numbness on tongue, seizure ( several minutes) came in and out of consciousness during it, eyes rolled back in head. Arms flailing.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1186023


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