National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1182133

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1182133
VAERS Form:2
Age:28.0
Sex:Unknown
Location:Tennessee
Vaccinated:2021-03-19
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 UN / -

Administered by: Private      Purchased by: ??
Symptoms: Antinuclear antibody, Chills, Dyspnoea, Eye pain, Feeling abnormal, Headache, Myalgia, Pain in jaw, Platelet count decreased, Pyrexia, Superior sagittal sinus thrombosis, Syncope, Thrombocytopenia, Ultrasound Doppler abnormal, Viral infection, Peripheral swelling, Contusion, Heparin-induced thrombocytopenia test, Deep vein thrombosis, Rhinalgia, Blood smear test normal, Laboratory test, Platelet factor 4, Coagulation test, Periorbital haemorrhage, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 3/25/21 Plt count 125K 4/6/21 Plt ct 34K, smear reviewed, no clumping, no schistocytes. Ordered hypercoag panel, ANA and Anti PF4/HIT (awaiting all results) CT and MRI of head with dural sinus thrombosis, Duplex US with RLE thrombosis.
CDC 'Split Type':

Write-up: She received the J and J vaccine on 3/19/21 at STM. She presented to Med center with a "viral syndrome" including fevers, rigors, muscle pain and SOB. She received a Z pack. Fever persisted for 1 day after ER visit but she continued to feel badly. The following day, 3/27 she was awakened with severe R$gL jaw pain, post HA with standing, pain in the cartilage on the tip of her nose and SOB. SOB resolved by 3/31. HAS persisted as did jaw pain and pain behind her eyes. ON 3/30 she noted increasing bruising and periorbital petechiae which continued through 4/5 when she sought help from Dr , her PcP. When she saw DR she was noted to have bilateral leg swelling R$g$gL . She had labs and a Doppler US which we are trying to locate. She had a syncopal spell on 4/6 and was brought to ER at STM where she was diagnosed with sagittal vein thrombosis, RLE DVT and thrombocytopenia.


Changed on 5/7/2021

VAERS ID: 1182133 Before After
VAERS Form:2
Age:28.0
Sex:Unknown
Location:Tennessee
Vaccinated:2021-03-19
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 UN / -

Administered by: Private      Purchased by: ??
Symptoms: Antinuclear antibody, Chills, Dyspnoea, Eye pain, Feeling abnormal, Headache, Myalgia, Pain in jaw, Platelet count decreased, Pyrexia, Superior sagittal sinus thrombosis, Syncope, Thrombocytopenia, Ultrasound Doppler abnormal, Viral infection, Peripheral swelling, Contusion, Heparin-induced thrombocytopenia test, Deep vein thrombosis, Rhinalgia, Blood smear test normal, Laboratory test, Platelet factor 4, Coagulation test, Periorbital haemorrhage, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: 3/25/21 Plt count 125K 4/6/21 Plt ct 34K, smear reviewed, no clumping, no schistocytes. Ordered hypercoag panel, ANA and Anti PF4/HIT (awaiting all results) CT and MRI of head with dural sinus thrombosis, Duplex US with RLE thrombosis.
CDC 'Split Type':

Write-up: She received the J and J vaccine on 3/19/21 at STM. She presented to Med center with a "viral syndrome" including fevers, rigors, muscle pain and SOB. She received a Z pack. Fever persisted for 1 day after ER visit but she continued to feel badly. The following day, 3/27 she was awakened with severe R$gL jaw pain, post HA with standing, pain in the cartilage on the tip of her nose and SOB. SOB resolved by 3/31. HAS persisted as did jaw pain and pain behind her eyes. ON 3/30 she noted increasing bruising and periorbital petechiae which continued through 4/5 when she sought help from Dr , her PcP. When she saw DR she was noted to have bilateral leg swelling R$g$gL . She had labs and a Doppler US which we are trying to locate. She had a syncopal spell on 4/6 and was brought to ER at STM where she was diagnosed with sagittal vein thrombosis, RLE DVT and thrombocytopenia.


Changed on 5/14/2021

VAERS ID: 1182133 Before After
VAERS Form:2
Age:28.0
Sex:Unknown
Location:Tennessee
Vaccinated:2021-03-19
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 UN / -

Administered by: Private      Purchased by: ??
Symptoms: Antinuclear antibody, Chills, Dyspnoea, Eye pain, Feeling abnormal, Headache, Myalgia, Pain in jaw, Platelet count decreased, Pyrexia, Superior sagittal sinus thrombosis, Syncope, Thrombocytopenia, Ultrasound Doppler abnormal, Viral infection, Peripheral swelling, Contusion, Heparin-induced thrombocytopenia test, Deep vein thrombosis, Rhinalgia, Blood smear test normal, Laboratory test, Platelet factor 4, Coagulation test, Periorbital haemorrhage, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: 3/25/21 Plt count 125K 4/6/21 Plt ct 34K, smear reviewed, no clumping, no schistocytes. Ordered hypercoag panel, ANA and Anti PF4/HIT (awaiting all results) CT and MRI of head with dural sinus thrombosis, Duplex US with RLE thrombosis.
CDC 'Split Type':

Write-up: She received the J and J vaccine on 3/19/21 at STM. She presented to Med center with a "viral syndrome" including fevers, rigors, muscle pain and SOB. She received a Z pack. Fever persisted for 1 day after ER visit but she continued to feel badly. The following day, 3/27 she was awakened with severe R$gL jaw pain, post HA with standing, pain in the cartilage on the tip of her nose and SOB. SOB resolved by 3/31. HAS persisted as did jaw pain and pain behind her eyes. ON 3/30 she noted increasing bruising and periorbital petechiae which continued through 4/5 when she sought help from Dr , her PcP. When she saw DR she was noted to have bilateral leg swelling R$g$gL . She had labs and a Doppler US which we are trying to locate. She had a syncopal spell on 4/6 and was brought to ER at STM where she was diagnosed with sagittal vein thrombosis, RLE DVT and thrombocytopenia.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1182133&WAYBACKHISTORY=ON


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