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This is VAERS ID 1384335

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1384335
VAERS Form:2
Age:59.0
Sex:Male
Location:Connecticut
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Blood glucose, Dehydration, Dizziness, Loss of consciousness, Cardiovascular evaluation, Blood pressure measurement

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:
Other Medications:
Current Illness: Alcohol use; Blood pressure high; High cholesterol; Stroke (The patient had storke like symptoms but was not diagnosed as stroke because all tests were negative but still had the symptoms.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: Blood pressure; Result Unstructured Data: Normal; Test Date: 20210605; Test Name: Cardiovascular evaluation; Result Unstructured Data: Normal; Test Date: 20210605; Test Name: Blood glucose; Result Unstructured Data: Normal
CDC 'Split Type': USJNJFOC20210613161

Write-up: PASSED OUT; LIGHT HEADED; DEHYDRATED; FELT WEAK; This spontaneous report received from a patient concerned a 59 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included controlled high blood pressure, controlled high cholesterol, stroke like symptoms in MAR-20219, however he was not diagnosed as having stroke because all tests were negative but he still had the symptoms, and alcohol use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821288, and expiry: UNKNOWN) 1 total, dose was not reported, administered on left arm on 04-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-JUN-2021 after vaccination, the patient felt weak but it was not significant. On 05-JUN-2021, the patient felt weak while doing daily activities. The patient had not felt anything and had breakfast. He got in the sun and got dehydrated as not had water for three hours during the day. Later, he got water. The patient had taken one drink of alcohol, sat down and got light headed then passed out for less than a minute. It was reported that, upon contacting emergency services advised patient to visit emergency room to check him as a precaution but the patient denied. It was reported that, the patient''s heart, blood pressure, and blood glucose were normal. The patient was fine at the time of this report. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from passed out on 05-JUN-2021, and light headed, dehydrated, and felt weak on JUN-2021. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210613161-covid-19 vaccine ad26.cov2.s-passed out. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).

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