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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1251176



Case Details

VAERS ID: 1251176 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Angiogram pulmonary abnormal, Colitis, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal, Computerised tomogram pelvis abnormal, Computerised tomogram thorax abnormal, Mesenteric vein thrombosis, Platelet count decreased, Portal vein thrombosis, Pulmonary embolism, Splenomegaly, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT angio of Chest, Abdomen, Pelvis and Head Blood work showing: 1) Bilateral acute appearing pulmonary embolism right greater than left, clot burden moderately large. 2) . Probable portal vein thrombosis with partial superior mesenteric vein thrombosis. 3) Changes of mild diffuse colitis are suspect. Potential etiologies for colitis includes infectious processes, inflammatory processes, as well as ischemic etiologies. 4) Splenomegaly. 5) Thrombocytopenia. Platelets of 39000
CDC Split Type:

Write-up: 1) Bilateral acute appearing pulmonary embolism right greater than left, clot burden moderately large. 2) . Probable portal vein thrombosis with partial superior mesenteric vein thrombosis. 3) Changes of mild diffuse colitis are suspect. Potential etiologies for colitis includes infectious processes, inflammatory processes, as well as ischemic etiologies. 4) Splenomegaly. 5) Thrombocytopenia. Platelets of 39000


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251176


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