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This is VAERS ID 1331022

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1331022
VAERS Form:2
Age:31.0
Sex:Male
Location:Texas
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: Dizziness, Fall, 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: patient became light-headed after immunization and fainted, falling off of the chair. Emergency services were called and he was determined to be okay.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331022&WAYBACKHISTORY=ON


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