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This is VAERS ID 1236681

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1236681
VAERS Form:2
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-07
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound Doppler abnormal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: dx 4/15/21 with LE venous duplex
CDC 'Split Type':

Write-up: RLE DVT--Acute, occlusive deep vein thrombosis in the right gastrocnemius vein--started on anticoagulant--apixaban


Changed on 5/7/2021

VAERS ID: 1236681 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-07
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound Doppler abnormal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: dx 4/15/21 with LE venous duplex
CDC 'Split Type':

Write-up: RLE DVT--Acute, occlusive deep vein thrombosis in the right gastrocnemius vein--started on anticoagulant--apixaban


Changed on 5/14/2021

VAERS ID: 1236681 Before After
VAERS Form:2
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-07
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound Doppler abnormal, Deep vein thrombosis

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: dx 4/15/21 with LE venous duplex
CDC 'Split Type':

Write-up: RLE DVT--Acute, occlusive deep vein thrombosis in the right gastrocnemius vein--started on anticoagulant--apixaban

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1236681&WAYBACKHISTORY=ON

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