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This is VAERS ID 1250901

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1250901
VAERS Form:2
Age:71.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-08
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Pulmonary embolism, Peripheral embolism, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dilaudid morphine Lasix
Current Illness: Copd
Preexisting Conditions: Copd
Allergies: None
Diagnostic Lab Data: Chest X-ray and blood work
CDC 'Split Type':

Write-up: Blood clots in each lung and leg


Changed on 5/7/2021

VAERS ID: 1250901 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-08
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Pulmonary embolism, Peripheral embolism, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dilaudid morphine Lasix
Current Illness: Copd
Preexisting Conditions: Copd
Allergies: None None
Diagnostic Lab Data: Chest X-ray and blood work
CDC 'Split Type':

Write-up: Blood clots in each lung and leg


Changed on 5/14/2021

VAERS ID: 1250901 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-08
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Pulmonary embolism, Peripheral embolism, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dilaudid morphine Lasix
Current Illness: Copd
Preexisting Conditions: Copd
Allergies: None None
Diagnostic Lab Data: Chest X-ray and blood work
CDC 'Split Type':

Write-up: Blood clots in each lung and leg

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1250901&WAYBACKHISTORY=ON


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