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This is VAERS ID 1758604

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1758604
VAERS Form:2
Age:74.0
Sex:Male
Location:California
Vaccinated:2021-09-30
Onset:2021-10-02
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Asthenia, Cerebrovascular accident, Swelling, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: Statin drugs
Diagnostic Lab Data: Various Tests Ran
CDC 'Split Type':

Write-up: Woke up and entire left side of body was swollen and dragging. Went to the ER and was admitted and diagnosed with a stroke.

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