National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/4/2021 release of VAERS data:

This is VAERS ID 1230196

Case Details

VAERS ID: 1230196 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Thrombophlebitis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Clindamycin, Crestor, Tri Femynor (birth control)
Current Illness: None
Preexisting Conditions: Hyperlipidemia, long QT syndrome and Attention deficit disorder
Allergies: NKDA
Diagnostic Lab Data: U/S 4/19/21
CDC Split Type:

Write-up: pt had left upper arm pain and found on ultrasound 4/19/21 to have a superficial thrombophlebitis

New Search

Link To This Search Result:

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