National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1775341

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775341
VAERS Form:2
Age:41.0
Sex:Male
Location:Washington
Vaccinated:2021-10-09
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Malaise, Pallor, Visual impairment

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt is here for Johnson and Johnson vaccine, received at 1745. At 1746, while still at vaccination table, PT reported that he didn?t feel well and presented with diaphoresis, pallor, a sensation of being hot and light-headed, reported that his vision was dimming/everything was getting darker. No LOC noted. PT provided ice pack at 1747, applied to back of neck. PT reports that this has happened to him before with blood draws and that he had severe phobia r/t needles. PT also reported it had been about 6 hours since he?d eaten, but he declined the juice offered before his vaccination. He also reports that he has lost 35 LBS in 3 months r/t a diet. VS at 1746: HR 56, SPO2 98% %A. At 1755: BP sitting is 90/60, HR is 76, SPO2 is 98%. At 1800, BP sitting is 118/80, HR is 84, SPO2 98% and PT is reported he feels ?100% better.?. At 1803, PT continued with diaphoresis, but color had improved. PT accepted apple juice. At 1808, PT stood from chair unassisted with steady gait. Pt denied SOB, respiratory distress, itching. At 1828, PT exited facility with steady gait, stable and able to walk on his own, denying dizziness and reporting that he ?feels good.?.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1775341&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166