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This is VAERS ID 1328036

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328036
VAERS Form:2
Age:24.0
Sex:Female
Location:New York
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 206A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Anxiety

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: patient had an anxiety attack related to vaccine administration (needles) and potential side effects after administration. vitals : hr 50, r 30, BP 140/100,m o2 sat 88%. EMS was called due to dropping o2 sat and HR. vitals reached normal range after EMS arrived. final vitals upon leaving facility: HR 56, R 25, BP 138/90, O2SAT 99%. EMS took patient to mt sinai west in NYC for further observation.

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