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This is VAERS ID 1242632

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1242632
VAERS Form:2
Age:62.0
Sex:Female
Location:New Jersey
Vaccinated:2021-04-11
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Echocardiogram, Pulmonary embolism, Computerised tomogram thorax abnormal, Laboratory test

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fetzima, Seroquel - both for depression
Current Illness: none
Preexisting Conditions: depression
Allergies: penicillin -rash/hives
Diagnostic Lab Data: CT chest, labs, echo
CDC 'Split Type':

Write-up: extensive bilateral PE


Changed on 5/7/2021

VAERS ID: 1242632 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:New Jersey
Vaccinated:2021-04-11
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Echocardiogram, Pulmonary embolism, Computerised tomogram thorax abnormal, Laboratory test

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fetzima, Seroquel - both for depression
Current Illness: none
Preexisting Conditions: depression
Allergies: penicillin -rash/hives -rash/hives
Diagnostic Lab Data: CT chest, labs, echo
CDC 'Split Type':

Write-up: extensive bilateral PE


Changed on 5/14/2021

VAERS ID: 1242632 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:New Jersey
Vaccinated:2021-04-11
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Echocardiogram, Pulmonary embolism, Computerised tomogram thorax abnormal, Laboratory test

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fetzima, Seroquel - both for depression
Current Illness: none
Preexisting Conditions: depression
Allergies: penicillin -rash/hives -rash/hives
Diagnostic Lab Data: CT chest, labs, echo
CDC 'Split Type':

Write-up: extensive bilateral PE

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1242632&WAYBACKHISTORY=ON


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