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This is VAERS ID 1242694

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1242694
VAERS Form:2
Age:51.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Gait disturbance, Hypoaesthesia, Thrombosis, Ultrasound scan, Impaired driving ability, Lacunar infarction, Scan with contrast, Blood test, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinapril 10mg daily Montelukast 10mg daily Timolol Maleate 1 drop both eyes 2 times per day Venlafaxine 75mg daily Vitamin D3 25mcg daily Biotin 10,000mcg
Current Illness: UVitis - Retasert Implant Colon Rectal Cancer - Surgically removed no treatment or prescription required
Preexisting Conditions: Hypertension - no issues with daily Medication
Allergies: MRI dye
Diagnostic Lab Data: Chest Xray 03/20/21 CT scan with and without contrast 03/20/21 MRI with and without contrast 03/20/21 Echo with and without Bubble test 03/21/21 Cholesterol panel 03/21/21 Misc Blood work-specific test unknown
CDC 'Split Type':

Write-up: 03/19/21 woke up with numbness on whole right side of body (head to toe). Referred to ER by Family Physician on 03/20/21. admitted to hospital for testing. MRI confirmed a blood clot caused a Lacuna Infarcts Event (type of mini stroke) The patient continues to have numbness and difficulty walking, driving and has affected her normal daily activities. The patient will be required to start Plavix and baby aspirin. Waiting for requirement for Prolong numbness which affects her daily activity.


Changed on 5/7/2021

VAERS ID: 1242694 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Gait disturbance, Hypoaesthesia, Thrombosis, Ultrasound scan, Impaired driving ability, Lacunar infarction, Scan with contrast, Blood test, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinapril 10mg daily Montelukast 10mg daily Timolol Maleate 1 drop both eyes 2 times per day Venlafaxine 75mg daily Vitamin D3 25mcg daily Biotin 10,000mcg
Current Illness: UVitis - Retasert Implant Colon Rectal Cancer - Surgically removed no treatment or prescription required
Preexisting Conditions: Hypertension - no issues with daily Medication
Allergies: MRI dye dye
Diagnostic Lab Data: Chest Xray 03/20/21 CT scan with and without contrast 03/20/21 MRI with and without contrast 03/20/21 Echo with and without Bubble test 03/21/21 Cholesterol panel 03/21/21 Misc Blood work-specific test unknown
CDC 'Split Type':

Write-up: 03/19/21 woke up with numbness on whole right side of body (head to toe). Referred to ER by Family Physician on 03/20/21. admitted to hospital for testing. MRI confirmed a blood clot caused a Lacuna Infarcts Event (type of mini stroke) The patient continues to have numbness and difficulty walking, driving and has affected her normal daily activities. The patient will be required to start Plavix and baby aspirin. Waiting for requirement for Prolong numbness which affects her daily activity.


Changed on 5/14/2021

VAERS ID: 1242694 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-08
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Computerised tomogram, Gait disturbance, Hypoaesthesia, Thrombosis, Ultrasound scan, Impaired driving ability, Lacunar infarction, Scan with contrast, Blood test, Magnetic resonance imaging head abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinapril 10mg daily Montelukast 10mg daily Timolol Maleate 1 drop both eyes 2 times per day Venlafaxine 75mg daily Vitamin D3 25mcg daily Biotin 10,000mcg
Current Illness: UVitis - Retasert Implant Colon Rectal Cancer - Surgically removed no treatment or prescription required
Preexisting Conditions: Hypertension - no issues with daily Medication
Allergies: MRI dye dye
Diagnostic Lab Data: Chest Xray 03/20/21 CT scan with and without contrast 03/20/21 MRI with and without contrast 03/20/21 Echo with and without Bubble test 03/21/21 Cholesterol panel 03/21/21 Misc Blood work-specific test unknown
CDC 'Split Type':

Write-up: 03/19/21 woke up with numbness on whole right side of body (head to toe). Referred to ER by Family Physician on 03/20/21. admitted to hospital for testing. MRI confirmed a blood clot caused a Lacuna Infarcts Event (type of mini stroke) The patient continues to have numbness and difficulty walking, driving and has affected her normal daily activities. The patient will be required to start Plavix and baby aspirin. Waiting for requirement for Prolong numbness which affects her daily activity.

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