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This is VAERS ID 1330640

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1330640
VAERS Form:2
Age:71.0
Sex:Female
Location:Tennessee
Vaccinated:2021-05-19
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Cold sweat, Dizziness, Loss of consciousness, Syncope, Unresponsive to stimuli

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT AVAILABLE
Current Illness: NONE
Preexisting Conditions: ATRIAL FIBRILLATION
Allergies: NONE
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: PATIENT GOT DIZZY WITHIN 5 MINUTES OF RECEIVING VACCINE-BECAME UNRESPONSIVE FOR ABOUT 30 SECONDS. SHE CONTINUED TO BE DIZZY/FAINT AND HAD A COLD SWEAT. PT WAS NOT INJURED WITH LOSS OF CONSIOUSNESS. CALLED 911, EMS ARRIVED AND TOOK PATIENT TO THE HOSPITAL. WHILE WAITING FOR EMS BLOOD PRESSURE AND HR CHECKS WERE PERFORMED WHILE PATIENT WAS IN LAYING DOWN POSITION.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1330640&WAYBACKHISTORY=ON


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