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This is VAERS ID 1328714

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328714
VAERS Form:2
Age:25.0
Sex:Male
Location:Washington
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 - / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: WITHIN SEVERAL MINUTES OF RECEIVING THE VACCINATION THE PATIENT PASSED OUT, REGAINING CONSCIOUSNESS WITHIN 1 MINUTE

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328714&WAYBACKHISTORY=ON


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