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This is VAERS ID 1024515

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1024515
VAERS Form:2
Age:48.0
Sex:Female
Location:Ohio
Vaccinated:2021-01-14
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram, Pneumonia, Pulmonary embolism, Ultrasound scan, X-ray, Blood test, SARS-CoV-2 test

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: Bupropion sertraline amlodipine losartan hydrochlorothiazide omeprazole levothyroxine ibuprofen acetaminophen stelara
Current Illness: None
Preexisting Conditions: Thyroid high blood pressure depression reflux psoriasis
Allergies: Ivp dye lisinopril tramadol
Diagnostic Lab Data: Covid test blood work cat scans ultrasounds of legs and heart X-ray between 2/2-2/7/2021
CDC 'Split Type':

Write-up: Developed bi lateral pulmonary embolisms (multiple) and pneumonia in left lung


Changed on 5/14/2021

VAERS ID: 1024515 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Ohio
Vaccinated:2021-01-14
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram, Pneumonia, Pulmonary embolism, Ultrasound scan, X-ray, Blood test, SARS-CoV-2 test

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: Bupropion sertraline amlodipine losartan hydrochlorothiazide omeprazole levothyroxine ibuprofen acetaminophen stelara
Current Illness: None
Preexisting Conditions: Thyroid high blood pressure depression reflux psoriasis
Allergies: Ivp dye lisinopril tramadol tramadol
Diagnostic Lab Data: Covid test blood work cat scans ultrasounds of legs and heart X-ray between 2/2-2/7/2021
CDC 'Split Type':

Write-up: Developed bi lateral pulmonary embolisms (multiple) and pneumonia in left lung

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1024515&WAYBACKHISTORY=ON


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