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This is VAERS ID 1249516

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249516
VAERS Form:2
Age:
Sex:Male
Location:California
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18052029 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Dizziness, Fatigue, Headache, Panic attack, Balance disorder, Polymerase chain reaction

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hypertension; Non-smoker
Preexisting Conditions: Comments: Patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: PCR; Result Unstructured Data: Negative
CDC 'Split Type': USJNJFOC20210442961

Write-up: PANIC ATTACK; DIZZINESS; HEADACHE; VERY FATIGUE; LOSS OF BALANCE; CONFUSION; This spontaneous report received from a consumer concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, non alcoholic, and non smoker, and other pre-existing medical conditions included patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 18052029 expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On FEB-2021, Laboratory data included: PCR (NR: not provided) Negative. On 12-APR-2021, the subject experienced loss of balance. On 12-APR-2021, the subject experienced confusion. On 12-APR-2021, the subject experienced dizziness. On 12-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced very fatigue. On 15-APR-2021, the subject experienced panic attack. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from panic attack on 16-APR-2021, and had not recovered from loss of balance, headache, confusion, very fatigue, and dizziness. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1249516 Before After
VAERS Form:2
Age:
Sex:Male
Location:California
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18052029 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Dizziness, Fatigue, Headache, Panic attack, Balance disorder, Polymerase chain reaction

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hypertension; Non-smoker
Preexisting Conditions: Comments: Patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: PCR; Result Unstructured Data: Negative
CDC 'Split Type': USJNJFOC20210442961

Write-up: PANIC ATTACK; DIZZINESS; HEADACHE; VERY FATIGUE; LOSS OF BALANCE; CONFUSION; This spontaneous report received from a consumer concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, non alcoholic, and non smoker, and other pre-existing medical conditions included patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 18052029 expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On FEB-2021, Laboratory data included: PCR (NR: not provided) Negative. On 12-APR-2021, the subject experienced loss of balance. On 12-APR-2021, the subject experienced confusion. On 12-APR-2021, the subject experienced dizziness. On 12-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced very fatigue. On 15-APR-2021, the subject experienced panic attack. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from panic attack on 16-APR-2021, and had not recovered from loss of balance, headache, confusion, very fatigue, and dizziness. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1249516 Before After
VAERS Form:2
Age:
Sex:Male
Location:California
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18052029 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Dizziness, Fatigue, Headache, Panic attack, Balance disorder, Polymerase chain reaction

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hypertension; Non-smoker
Preexisting Conditions: Comments: Patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: PCR; Result Unstructured Data: Negative
CDC 'Split Type': USJNJFOC20210442961

Write-up: PANIC ATTACK; DIZZINESS; HEADACHE; VERY FATIGUE; LOSS OF BALANCE; CONFUSION; This spontaneous report received from a consumer concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, non alcoholic, and non smoker, and other pre-existing medical conditions included patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 18052029 expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On FEB-2021, Laboratory data included: PCR (NR: not provided) Negative. On 12-APR-2021, the subject experienced loss of balance. On 12-APR-2021, the subject experienced confusion. On 12-APR-2021, the subject experienced dizziness. On 12-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced very fatigue. On 15-APR-2021, the subject experienced panic attack. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from panic attack on 16-APR-2021, and had not recovered from loss of balance, headache, confusion, very fatigue, and dizziness. This report was non-serious.

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