National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1364855

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1364855
VAERS Form:2
Age:46.0
Sex:Male
Location:Florida
Vaccinated:2021-04-29
Onset:2021-04-30
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Dizziness, Headache, Nausea, Vision blurred, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: High blood pressure
Preexisting Conditions: High blood pressure, high cholesterol, CAD
Allergies: None
Diagnostic Lab Data: Vertigo test
CDC 'Split Type':

Write-up: Dizziness, blurred vision, headache, nausea

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1364855&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166