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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||041A21A / 1||LA / IM|
Administered by: Other Purchased by: ??
Symptoms: Loss of consciousness, Pallor, Syncope
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Previous Vaccinations: Vasovagal history after vaccine or blood draw
Other Medications: PT states none
Current Illness: PT states none
Preexisting Conditions: PT states none
Allergies: PT states none
Diagnostic Lab Data: None
CDC 'Split Type':
Write-up: 24 male PT experienced syncopal episode approx 1 minute after receiving 1st dose Janssen COVID19 vaccine 041A21A IM Left deltoid which resulted in approx 5 seconds of unconsciousness. PT helped to floor by on site staff and placed in trendelenburg position. Staff called 911, obtained verbal consent for assessment, baseline vitals and demographics obtained. BP 110/70, SPO2 99%RA, Pulse 76 regular @ radial, skin CTC pale, cool, dry, and not trauma observed or stated. PT denies past medical history, denies medication use or non-compliance and states he has had 48oz of water in last 24hrs. PT denies any further medical complaint. Janssen assumed PT care at 1615. END REPORT
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