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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1236988



Case Details

VAERS ID: 1236988 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (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: diclofenac
Current Illness:
Preexisting Conditions: rosacea sleep apnea
Allergies: erythromycin peanuts sulfa tree nuts
Diagnostic Lab Data: Venous doppler
CDC Split Type:

Write-up: Acute deep vein thrombosis (DVT) of popliteal vein of left lower extremity


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1236988

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