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This is VAERS ID 1251532

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1251532
VAERS Form:2
Age:19.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Thrombosis, Adverse reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anovera 0.013-0.15 mg / 24 hr ring
Current Illness:
Preexisting Conditions: asthma and anemia
Allergies: no known allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient stated she needed to go to hospital for adverse reaction of pain in leg. After asking MD to check her leg, they discovered a blood clot per patient. She is now doing well per her.


Changed on 5/7/2021

VAERS ID: 1251532 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Thrombosis, Adverse reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anovera 0.013-0.15 mg / 24 hr ring
Current Illness:
Preexisting Conditions: asthma and anemia
Allergies: no known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient stated she needed to go to hospital for adverse reaction of pain in leg. After asking MD to check her leg, they discovered a blood clot per patient. She is now doing well per her.


Changed on 5/14/2021

VAERS ID: 1251532 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-10
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Thrombosis, Adverse reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anovera 0.013-0.15 mg / 24 hr ring
Current Illness:
Preexisting Conditions: asthma and anemia
Allergies: no known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient stated she needed to go to hospital for adverse reaction of pain in leg. After asking MD to check her leg, they discovered a blood clot per patient. She is now doing well per her.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251532&WAYBACKHISTORY=ON


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