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This is VAERS ID 1351939

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1351939
VAERS Form:2
Age:25.0
Sex:Male
Location:Missouri
Vaccinated:2021-05-26
Onset:2021-05-26
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Aphasia, Dizziness, Loss of consciousness, Visual impairment, Vomiting

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient received vaccine and with in minutes, became very light headed, vomited and lost consciousness. Patient became alert but still had trouble hearing, seeing and speaking, and vomited several more times. Paramedics arrived and transported to hospital

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