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This is VAERS ID 1371293

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371293
VAERS Form:2
Age:18.0
Sex:Female
Location:Missouri
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Anxiety, Dizziness, Pallor

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: meningitis, HPV
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received J&J vaccine and walked to sit down for her post injection wait time. Patient had previously fainted after a vaccine so she was suppose to sit for 30 minutes anyway. Patient immediately after sitting down got extremely light headed, pale, and dizzy. We immediately moved her to the floor and put her feet up. After approximately 3 minutes, patient regained color and was feeling a lot better. EMS was called but father who was with her called to cancel and refuse after patient felt better so quickly. Patient had history of anxiety with shots and it seemed to be truly an anxiety issue.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371293&WAYBACKHISTORY=ON


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