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This is VAERS ID 1248330

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1248330
VAERS Form:2
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:2021-03-09
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 5 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Muscle spasms, 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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: chronic
Allergies: n/a
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient has leg cramps starting on Monday, April 19th. She went to the hospital at later date. Doctor diagnosed her with leg clot.


Changed on 5/7/2021

VAERS ID: 1248330 Before After
VAERS Form:2
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:2021-03-09
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 5 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Muscle spasms, 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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: chronic
Allergies: n/a n/a
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient has leg cramps starting on Monday, April 19th. She went to the hospital at later date. Doctor diagnosed her with leg clot.


Changed on 5/14/2021

VAERS ID: 1248330 Before After
VAERS Form:2
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:2021-03-09
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 5 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Muscle spasms, 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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: chronic
Allergies: n/a n/a
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient has leg cramps starting on Monday, April 19th. She went to the hospital at later date. Doctor diagnosed her with leg clot.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1248330&WAYBACKHISTORY=ON


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