National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1328524

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328524
VAERS Form:2
Age:30.0
Sex:Male
Location:California
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 042A21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood glucose, Blood pressure decreased, Dizziness, Electrocardiogram, Hyperhidrosis, Loss of consciousness, Pallor

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: SAID HAPPENED WHEN YOUNGER AT DR OFFICE, DON''T KNOW WHAT KIND, BUT HE DIDN''T INDICATE THIS TO US BEFOREHAND ON FORM
Other Medications: NKA
Current Illness: NKA
Preexisting Conditions: NKA
Allergies: NKA
Diagnostic Lab Data: BP MONITORING, BLOOD SUGAR, EKG ON 5/18/21
CDC 'Split Type':

Write-up: PT WAS SEATED, WAITING FOR 15 MINUTE MONITORING PERIOD POST VACCINE ADMINISTRATION. FELT DIZZY. REMAINED SEATED BUT PASSED OUT FOR A FEW SECONDS. CALLED 911. CAME TO, WAS ABLE TO TALK AND BREATHE BUT WAS SWEATY AND DIZZY AND PALE. SAT ON FLOOR SO HE WOULDN''T SLIDE OFF CHAIR IN CASE HAPPENED AGAIN. PARAMEDICS CAME, MONITORED BP, BLOOD SUGAR, EKG. HE HAD LOW BP BUT IT CAME BACK TO NORMAL IN FEW MINUTES. PARAMEDICS DETERMINED HE WAS OK TO GO HOME, DIDN''T NEED TO GO TO HOSPITAL

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328524&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166