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This is VAERS ID 1212978

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1212978
VAERS Form:2
Age:38.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Gait inability, Thrombosis, Ultrasound scan abnormal

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: CLONAZEPAM 1 MG HCTZ 25 MG
Current Illness: NONE
Preexisting Conditions: SVT- SURFACE VEIN CLOTS DVT- LLE 2 YEARS AGO
Allergies: NKDA
Diagnostic Lab Data: Ultrasound of vein lower extremity 04-13-21
CDC 'Split Type':

Write-up: Pt states that on Monday she noticed that she couldn''t put pressure on her leg to walk. (04-12-21) Pt called and made an appointment on 04-13-21 and saw her PCP. Ultrasound was ordered and was dx with near occlusive vein thrombosis in the distal right femoral vein. Pt was prescribed Lovenox 100mg to take now and was also prescribed eliquis 5 mg twice daily, and acetaminophen-codeine to help with the pain.


Changed on 5/7/2021

VAERS ID: 1212978 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Gait inability, Thrombosis, Ultrasound scan abnormal

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: CLONAZEPAM 1 MG HCTZ 25 MG
Current Illness: NONE
Preexisting Conditions: SVT- SURFACE VEIN CLOTS DVT- LLE 2 YEARS AGO
Allergies: NKDA NKDA
Diagnostic Lab Data: Ultrasound of vein lower extremity 04-13-21
CDC 'Split Type':

Write-up: Pt states that on Monday she noticed that she couldn''t put pressure on her leg to walk. (04-12-21) Pt called and made an appointment on 04-13-21 and saw her PCP. Ultrasound was ordered and was dx with near occlusive vein thrombosis in the distal right femoral vein. Pt was prescribed Lovenox 100mg to take now and was also prescribed eliquis 5 mg twice daily, and acetaminophen-codeine to help with the pain.


Changed on 5/14/2021

VAERS ID: 1212978 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Gait inability, Thrombosis, Ultrasound scan abnormal

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: CLONAZEPAM 1 MG HCTZ 25 MG
Current Illness: NONE
Preexisting Conditions: SVT- SURFACE VEIN CLOTS DVT- LLE 2 YEARS AGO
Allergies: NKDA NKDA
Diagnostic Lab Data: Ultrasound of vein lower extremity 04-13-21
CDC 'Split Type':

Write-up: Pt states that on Monday she noticed that she couldn''t put pressure on her leg to walk. (04-12-21) Pt called and made an appointment on 04-13-21 and saw her PCP. Ultrasound was ordered and was dx with near occlusive vein thrombosis in the distal right femoral vein. Pt was prescribed Lovenox 100mg to take now and was also prescribed eliquis 5 mg twice daily, and acetaminophen-codeine to help with the pain.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212978&WAYBACKHISTORY=ON

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