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This is VAERS ID 1697392

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1697392
VAERS Form:2
Age:32.0
Sex:Male
Location:California
Vaccinated:2021-09-14
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood pressure decreased, Dizziness, Pain in extremity, Hot flush, Immediate post-injection reaction

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: MULTIVITAMIN, SYMBICORT INHALER
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: HORSEHAIR, SHELLFISH
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: LIGHTHEADED, DIZZY, HOT FLASHES IMMEDIATELY AFTER GIVING VACCINE. FELT VACCINE GO THROUGH ENTIRE BODY. DROP IN BLOOD PRESSURE. BP 3:30PM 92/55. 3:40PM BP 113/74. 3:47PM BP 126/80 HR 63. 3:57PM BP 128/88 HR 64. GAVE PATIENT WATER AND GRANOLA. AFTER 30 MINUTES PATIENT FELT NORMAL. FOLLWED UP WITH PATIENT 5:44PM. FELT NORMAL AND ONLY HAD ARM PAIN.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1697392&WAYBACKHISTORY=ON

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