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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||1808982 / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Fall, Head injury, Loss of consciousness
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)? Yes
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Gave patient vaccine at 9:55 AM. Patient was instructed to hang out seated in the pharmacy department for 15 minutes. Patient was feeling fine and proceeded to head to customer service counter in store where he lost consciousness falling forward hitting his face on the counter, and then fell back hitting the back of his head on the floor.
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