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This is VAERS ID 1237452

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1237452
VAERS Form:2
Age:21.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-07
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound scan, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto
Current Illness: Right distal fibular avulsion fracture.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultra sound of lower extremity
CDC 'Split Type':

Write-up: Acute deep vein thrombosis (DVT) of right peroneal vein


Changed on 5/7/2021

VAERS ID: 1237452 Before After
VAERS Form:2
Age:21.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-07
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound scan, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto
Current Illness: Right distal fibular avulsion fracture.
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Ultra sound of lower extremity
CDC 'Split Type':

Write-up: Acute deep vein thrombosis (DVT) of right peroneal vein


Changed on 5/14/2021

VAERS ID: 1237452 Before After
VAERS Form:2
Age:21.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-07
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound scan, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto
Current Illness: Right distal fibular avulsion fracture.
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Ultra sound of lower extremity
CDC 'Split Type':

Write-up: Acute deep vein thrombosis (DVT) of right peroneal vein

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1237452&WAYBACKHISTORY=ON

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