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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1351649

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Case Details

VAERS ID: 1351649 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Cardiac monitoring normal, Contusion, Dizziness, Electrocardiogram normal, Fall, Fatigue, Feeling abnormal, Impaired driving ability, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: dairy
Allergies: no
Diagnostic Lab Data: bloodwork - came back normal monitor the heart- everything was fine ekg
CDC Split Type: vsafe

Write-up: I woke up in the middle of night to use the bathroom and I don''t remember what I was feeling, but I kept telling my self to just finish peeing and I woke up on the ground, I was pretty out of it, it took a couple minutes to get out of it I had a couple of buries, I felt stages of light headed for a few days it felt like I was giving blood. The next day I felt off, I didn''t think I was safe to drive, I did feel better but still off and on Tuesday I felt drained.


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