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This is VAERS ID 1251686

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1251686
VAERS Form:2
Age:90.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Pulmonary embolism, Pyrexia, COVID-19

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Admitted to hospital with Covid 19 infection, fever, pulmonary embolism


Changed on 5/7/2021

VAERS ID: 1251686 Before After
VAERS Form:2
Age:90.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Pulmonary embolism, Pyrexia, COVID-19

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Admitted to hospital with Covid 19 infection, fever, pulmonary embolism


Changed on 5/14/2021

VAERS ID: 1251686 Before After
VAERS Form:2
Age:90.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-03-31
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Pulmonary embolism, Pyrexia, COVID-19

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Admitted to hospital with Covid 19 infection, fever, pulmonary embolism

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1251686&WAYBACKHISTORY=ON


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