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This is VAERS ID 1213493

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1213493
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2021-03-28
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / UN

Administered by: Other      Purchased by: ??
Symptoms: Blood pressure increased, Cerebral venous thrombosis, Chest pain, Dysphonia, Erythema of eyelid, Intensive care, Malaise, Swelling of eyelid, Venogram abnormal, Anticoagulant therapy, Computerised tomogram head abnormal, COVID-19, SARS-CoV-2 test positive, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: See hospital records. CT, MRI, MRV show dural venous filling defect.
CDC 'Split Type':

Write-up: Had COVID on 2/7/21- Feverish feeling x 1 day, fine after. Tested negative 2/17/21. One half hour after receiving the vaccine, onset of hoarseness. Severe hoarseness persists until today. Eyelids pink, swollen slightly, persisted 2 weeks. Did not feel well. 4/15/21 -Hospital Emergency Room. Chest pain. Elevated blood pressure. COVID test positive. Disharged with azithromycin, zinc sulfate 220mg, ProAir. High blood pressure, new onset. On 4/6/21 BP 160/120 both arms. 4/7/21 Hospital ER. MRI, CT brain showed Dural Venous Thrombosis. To ICU for anti coagulation, until 4/14/21. MRV done. Now on floors, started coumadin. 9 days hospitalization so far. CT done again 4/15/


Changed on 5/7/2021

VAERS ID: 1213493 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2021-03-28
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / UN

Administered by: Other      Purchased by: ??
Symptoms: Blood pressure increased, Cerebral venous thrombosis, Chest pain, Dysphonia, Erythema of eyelid, Intensive care, Malaise, Swelling of eyelid, Venogram abnormal, Anticoagulant therapy, Computerised tomogram head abnormal, COVID-19, SARS-CoV-2 test positive, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: None
Allergies: No No
Diagnostic Lab Data: See hospital records. CT, MRI, MRV show dural venous filling defect.
CDC 'Split Type':

Write-up: Had COVID on 2/7/21- Feverish feeling x 1 day, fine after. Tested negative 2/17/21. One half hour after receiving the vaccine, onset of hoarseness. Severe hoarseness persists until today. Eyelids pink, swollen slightly, persisted 2 weeks. Did not feel well. 4/15/21 -Hospital Emergency Room. Chest pain. Elevated blood pressure. COVID test positive. Disharged with azithromycin, zinc sulfate 220mg, ProAir. High blood pressure, new onset. On 4/6/21 BP 160/120 both arms. 4/7/21 Hospital ER. MRI, CT brain showed Dural Venous Thrombosis. To ICU for anti coagulation, until 4/14/21. MRV done. Now on floors, started coumadin. 9 days hospitalization so far. CT done again 4/15/


Changed on 5/14/2021

VAERS ID: 1213493 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2021-03-28
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / UN

Administered by: Other      Purchased by: ??
Symptoms: Blood pressure increased, Cerebral venous thrombosis, Chest pain, Dysphonia, Erythema of eyelid, Intensive care, Malaise, Swelling of eyelid, Venogram abnormal, Anticoagulant therapy, Computerised tomogram head abnormal, COVID-19, SARS-CoV-2 test positive, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: None
Allergies: No No
Diagnostic Lab Data: See hospital records. CT, MRI, MRV show dural venous filling defect.
CDC 'Split Type':

Write-up: Had COVID on 2/7/21- Feverish feeling x 1 day, fine after. Tested negative 2/17/21. One half hour after receiving the vaccine, onset of hoarseness. Severe hoarseness persists until today. Eyelids pink, swollen slightly, persisted 2 weeks. Did not feel well. 4/15/21 -Hospital Emergency Room. Chest pain. Elevated blood pressure. COVID test positive. Disharged with azithromycin, zinc sulfate 220mg, ProAir. High blood pressure, new onset. On 4/6/21 BP 160/120 both arms. 4/7/21 Hospital ER. MRI, CT brain showed Dural Venous Thrombosis. To ICU for anti coagulation, until 4/14/21. MRV done. Now on floors, started coumadin. 9 days hospitalization so far. CT done again 4/15/

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