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This is VAERS ID 1238108

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1238108
VAERS Form:2
Age:94.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-06
Onset:2021-04-19
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: Dizziness, Dyspnoea, Full blood count, Haematocrit decreased, Haemoglobin decreased, Platelet count decreased, Peripheral swelling, Immune thrombocytopenia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine besylate 205 mg daily q am Flonase 50 mcg q hs multivitamin oral daily q am
Current Illness:
Preexisting Conditions: high blood pressure bruises (several years, no change)
Allergies: Indocin (causes confusion)
Diagnostic Lab Data: CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.
CDC 'Split Type':

Write-up: Presented with 3 days of dizziness and shortness of breath, 3 weeks bilateral leg swelling without pain, redness, or warmth. No headaches, no bloody stool, no change in bruising patterns. Patient afebrile, stable vital signs, CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.


Changed on 5/7/2021

VAERS ID: 1238108 Before After
VAERS Form:2
Age:94.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-06
Onset:2021-04-19
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: Dizziness, Dyspnoea, Full blood count, Haematocrit decreased, Haemoglobin decreased, Platelet count decreased, Peripheral swelling, Immune thrombocytopenia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine besylate 205 mg daily q am Flonase 50 mcg q hs multivitamin oral daily q am
Current Illness:
Preexisting Conditions: high blood pressure bruises (several years, no change)
Allergies: Indocin (causes confusion) confusion)
Diagnostic Lab Data: CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.
CDC 'Split Type':

Write-up: Presented with 3 days of dizziness and shortness of breath, 3 weeks bilateral leg swelling without pain, redness, or warmth. No headaches, no bloody stool, no change in bruising patterns. Patient afebrile, stable vital signs, CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.


Changed on 5/14/2021

VAERS ID: 1238108 Before After
VAERS Form:2
Age:94.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-06
Onset:2021-04-19
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: Dizziness, Dyspnoea, Full blood count, Haematocrit decreased, Haemoglobin decreased, Platelet count decreased, Peripheral swelling, Immune thrombocytopenia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine besylate 205 mg daily q am Flonase 50 mcg q hs multivitamin oral daily q am
Current Illness:
Preexisting Conditions: high blood pressure bruises (several years, no change)
Allergies: Indocin (causes confusion) confusion)
Diagnostic Lab Data: CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.
CDC 'Split Type':

Write-up: Presented with 3 days of dizziness and shortness of breath, 3 weeks bilateral leg swelling without pain, redness, or warmth. No headaches, no bloody stool, no change in bruising patterns. Patient afebrile, stable vital signs, CBC remarkable for a platelet count of 2000 with immature platelet fraction of 69.8, hemoglobin 10.9, hematocrit 34.1. Diagnosis ITP.

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