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This is VAERS ID 1186023

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1186023
VAERS Form:2
Age:44.0
Sex:Male
Location:Tennessee
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 041A21A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Dyskinesia, Dyspnoea, Hyperhidrosis, Seizure, Consciousness fluctuating, Hypoaesthesia oral, Hot flush, Eye movement disorder, Blood test

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)? 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.


Changed on 5/7/2021

VAERS ID: 1186023 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Tennessee
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 041A21A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Dyskinesia, Dyspnoea, Hyperhidrosis, Seizure, Consciousness fluctuating, Hypoaesthesia oral, Hot flush, Eye movement disorder, Blood test

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Men?s one a day Glucosamine
Current Illness: None
Preexisting Conditions: None
Allergies: None 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.


Changed on 5/14/2021

VAERS ID: 1186023 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Tennessee
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 041A21A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Dyskinesia, Dyspnoea, Hyperhidrosis, Seizure, Consciousness fluctuating, Hypoaesthesia oral, Hot flush, Eye movement disorder, Blood test

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Men?s one a day Glucosamine
Current Illness: None
Preexisting Conditions: None
Allergies: None 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1186023&WAYBACKHISTORY=ON


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