Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||202A21A / 1||RA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Dizziness, Hypotension, Paraesthesia, Tinnitus, Immediate post-injection reaction
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: NONE REPORTED
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Diagnostic Lab Data: On day of event (6/3/2021), patient blood pressure, pulse oximetry, heart rate, and respirations monitored by pharmacy staff until EMS arrived. Patient was hypotensive, oxygen saturation of $g95% on room air, Patient was provided water and evaluated by EMS. EMS confirmed no life-threatening event associated with vaccination. Patient was encouraged to follow-up with medical provider as soon as leaving the facility by both EMS and pharmacy staff.
CDC 'Split Type':
Write-up: Immediately following administration of the vaccine, the patient reported lightheadedness, tinnitus, and paresthesia of extremities. Patient experienced these symptoms within 15 seconds of vaccine administration. Symptoms persisted for approximately 15 minutes.
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166