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This is VAERS ID 1328283

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328283
VAERS Form:2
Age:20.0
Sex:Male
Location:Texas
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 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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

Write-up: Syncope with what appeared as a short seizure. Patient placed flat on floor and at that time he asked "Where am I"? Respiration good, pulse good, no discoloration, no swelling , and not cold or clammy. While tending to patient a tech-in-training called 911. First responders arrived approximately 5 or 10 minutes later and followed up with the patient. He states he has never had a reaction to a flu vaccine but does not like to see the shot being given. He said that he could feel the medicine going into his muscle and it made him feel weird and doesn''t remember anything after that until he asked "Where am I"? He stayed another 10 minutes and said he felt fine. His brother drove him home.

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