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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||207A21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Fall, Head injury, Loss of consciousness
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Previous Vaccinations: syncope
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Diagnostic Lab Data: none
CDC 'Split Type':
Write-up: Patient received a dose of the Jassen covid vaccine and was sitting in the waiting room for his 15 minutes of observation. After about 10 minutes he passed out and fell out of his chair bumping his head on the way down.
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