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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1230771



Case Details

VAERS ID: 1230771 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60mg Pantoprazole 40mg Bupropion HCL XL 300mg Zolpidem 10mg Docusate Calcium 240mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound
CDC Split Type:

Write-up: Deep Vein Thrombosis in lower right leg


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230771

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