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This is VAERS ID 1236988

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1236988
VAERS Form:2
Age:55.0
Sex:Female
Location:Virginia
Vaccinated:2021-04-06
Onset:2021-04-14
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: Ultrasound Doppler abnormal, Deep vein thrombosis

Life Threatening? No
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? 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


Changed on 5/7/2021

VAERS ID: 1236988 Before After
VAERS Form:2
Age:55.0
Sex:Female
Location:Virginia
Vaccinated:2021-04-06
Onset:2021-04-14
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: Ultrasound Doppler abnormal, Deep vein thrombosis

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: diclofenac
Current Illness:
Preexisting Conditions: rosacea sleep apnea
Allergies: erythromycin peanuts sulfa tree nuts nuts
Diagnostic Lab Data: Venous doppler
CDC 'Split Type':

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


Changed on 5/14/2021

VAERS ID: 1236988 Before After
VAERS Form:2
Age:55.0
Sex:Female
Location:Virginia
Vaccinated:2021-04-06
Onset:2021-04-14
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: Ultrasound Doppler abnormal, Deep vein thrombosis

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: diclofenac
Current Illness:
Preexisting Conditions: rosacea sleep apnea
Allergies: erythromycin peanuts sulfa tree nuts 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1236988&WAYBACKHISTORY=ON

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