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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER||212A21A / 1||LA / IM|
Administered by: Other Purchased by: ??
Symptoms: Dizziness, Loss of consciousness, Memory impairment, Muscle twitching, Eye movement disorder
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
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Client passed out approximately 2 minutes after receiving J&J vaccine, client had no recollection of passing out after, rolling back of eyes and slight right arm muscle twitch upon awakening. On site EMS called to client''s side, observation provided . Client stated he did not remember passing out but he does remember feeling dizzy prior to passing out, Pt awoke within less than a minute. Client has no history of fainting.
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