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This is VAERS ID 1327528

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1327528
VAERS Form:2
Age:21.0
Sex:Male
Location:Maine
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Amnesia, Blood glucose, Hyperhidrosis, Loss of consciousness, Muscular weakness, Posture abnormal

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: none reported
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: do not have this info
CDC 'Split Type':

Write-up: vaccine adm @ 12:35 pm 5/18/2021 ,first event occurred 12:37 pm (passed out/muscle weakness(slumping)/ when over has no memory of event total time 5-7 seconds, then alert some sweating. second event same as first occurred 5 minutes later( was given water after first event.) CALLED 911 ARRIVED 5-10 MINUTES AFTER SECOND EVENT. after exam bp/blood glucose/pules/O2 sat/all normal(per emt) patient walked out under own power

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