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This is VAERS ID 1213215

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1213215
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Blood iron decreased, Endoscopy upper gastrointestinal tract normal, Haemoglobin decreased, Pain in extremity, Deep vein thrombosis, Mineral supplementation, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Laboratory test, Ultrasound scan abnormal, Transfusion

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)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC Omeprazole
Current Illness: None
Preexisting Conditions: GERD and Hiatal Hernia
Allergies: NKA
Diagnostic Lab Data: As listed above but also had blood work in a follow up appointment with Doctor on 04/13/21 (results not known at this time) and have scheduled another ultrasound on 05/17/21 for DVT check. Awaiting approval for capsule endoscopy.
CDC 'Split Type':

Write-up: On 3/12/21 developed pain in left calf area. Pain continued to progress and became extremely painful by April 2, 2021. April 3rd went to urgent care for assessment. Sent from urgent care to Lab for ultrasound of left calf which came back positive for DVT. Sent to ER and started on IV heparin. Also received CT Scan of Chest and Abdomen which showed PE in right lower lobe of lung. Admitted to Vascular unit. Doctor ordered an upper Endoscopy to check for bleeding due to low HGB and FE. The Scope was negative for bleeding. Lab work was ordered on 04/06/21 and due to very low HGB and FE patient was given an FE (iron) infusion the evening of 4/06/21 and again the morning of 04/07/21. The patient also received a unit of blood the morning of 04/07/21 prior to being discharged from the hospital. Patient was started on Eliquis 5mg 2x a day, Ferrus Sulfate 325mg 1x a day and Omeprazole 20mg 1x a day as discharge medications.


Changed on 5/7/2021

VAERS ID: 1213215 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Blood iron decreased, Endoscopy upper gastrointestinal tract normal, Haemoglobin decreased, Pain in extremity, Deep vein thrombosis, Mineral supplementation, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Laboratory test, Ultrasound scan abnormal, Transfusion

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)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC Omeprazole
Current Illness: None
Preexisting Conditions: GERD and Hiatal Hernia
Allergies: NKA NKA
Diagnostic Lab Data: As listed above but also had blood work in a follow up appointment with Doctor on 04/13/21 (results not known at this time) and have scheduled another ultrasound on 05/17/21 for DVT check. Awaiting approval for capsule endoscopy.
CDC 'Split Type':

Write-up: On 3/12/21 developed pain in left calf area. Pain continued to progress and became extremely painful by April 2, 2021. April 3rd went to urgent care for assessment. Sent from urgent care to Lab for ultrasound of left calf which came back positive for DVT. Sent to ER and started on IV heparin. Also received CT Scan of Chest and Abdomen which showed PE in right lower lobe of lung. Admitted to Vascular unit. Doctor ordered an upper Endoscopy to check for bleeding due to low HGB and FE. The Scope was negative for bleeding. Lab work was ordered on 04/06/21 and due to very low HGB and FE patient was given an FE (iron) infusion the evening of 4/06/21 and again the morning of 04/07/21. The patient also received a unit of blood the morning of 04/07/21 prior to being discharged from the hospital. Patient was started on Eliquis 5mg 2x a day, Ferrus Sulfate 325mg 1x a day and Omeprazole 20mg 1x a day as discharge medications.


Changed on 5/14/2021

VAERS ID: 1213215 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-04
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Blood iron decreased, Endoscopy upper gastrointestinal tract normal, Haemoglobin decreased, Pain in extremity, Deep vein thrombosis, Mineral supplementation, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Laboratory test, Ultrasound scan abnormal, Transfusion

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)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC Omeprazole
Current Illness: None
Preexisting Conditions: GERD and Hiatal Hernia
Allergies: NKA NKA
Diagnostic Lab Data: As listed above but also had blood work in a follow up appointment with Doctor on 04/13/21 (results not known at this time) and have scheduled another ultrasound on 05/17/21 for DVT check. Awaiting approval for capsule endoscopy.
CDC 'Split Type':

Write-up: On 3/12/21 developed pain in left calf area. Pain continued to progress and became extremely painful by April 2, 2021. April 3rd went to urgent care for assessment. Sent from urgent care to Lab for ultrasound of left calf which came back positive for DVT. Sent to ER and started on IV heparin. Also received CT Scan of Chest and Abdomen which showed PE in right lower lobe of lung. Admitted to Vascular unit. Doctor ordered an upper Endoscopy to check for bleeding due to low HGB and FE. The Scope was negative for bleeding. Lab work was ordered on 04/06/21 and due to very low HGB and FE patient was given an FE (iron) infusion the evening of 4/06/21 and again the morning of 04/07/21. The patient also received a unit of blood the morning of 04/07/21 prior to being discharged from the hospital. Patient was started on Eliquis 5mg 2x a day, Ferrus Sulfate 325mg 1x a day and Omeprazole 20mg 1x a day as discharge medications.

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