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This is VAERS ID 1212147

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1212147
VAERS Form:2
Age:43.0
Sex:Female
Location:Florida
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Pain in extremity, Platelet count normal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications: Insulin glargine
Current Illness: N/A
Preexisting Conditions: Diabetes
Allergies: No known drug allergies
Diagnostic Lab Data: None at the time of presentation. Noting platelet counts normal at the time.
CDC 'Split Type':

Write-up: Patient presented with leg pain and shortness of breath to the emergency department. Was subsequently found to have a DVT


Changed on 5/7/2021

VAERS ID: 1212147 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Florida
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Pain in extremity, Platelet count normal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications: Insulin glargine
Current Illness: N/A
Preexisting Conditions: Diabetes
Allergies: No known drug allergies allergies
Diagnostic Lab Data: None at the time of presentation. Noting platelet counts normal at the time.
CDC 'Split Type':

Write-up: Patient presented with leg pain and shortness of breath to the emergency department. Was subsequently found to have a DVT


Changed on 5/14/2021

VAERS ID: 1212147 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Florida
Vaccinated:2021-04-09
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Pain in extremity, Platelet count normal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications: Insulin glargine
Current Illness: N/A
Preexisting Conditions: Diabetes
Allergies: No known drug allergies allergies
Diagnostic Lab Data: None at the time of presentation. Noting platelet counts normal at the time.
CDC 'Split Type':

Write-up: Patient presented with leg pain and shortness of breath to the emergency department. Was subsequently found to have a DVT

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212147&WAYBACKHISTORY=ON

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