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This is VAERS ID 1257659

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1257659
VAERS Form:2
Age:98.0
Sex:Female
Location:New York
Vaccinated:2021-03-16
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Anticoagulant therapy

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: alendronate (FOSAMAX) 70 mg by mouth once a week furosemide (Lasix) 20 mg tablet Take 1 tablet (20 mg total) by mouth daily NIFEdipine (ADALAT CC) 30 mg ER tablet Take 1 tablet (30 mg total) by mouth daily omeprazole (PriLOSEC) 40 mg
Current Illness: NA
Preexisting Conditions: hypertension, osteoporosis
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute occlusive deep vein thrombosis noted in the left proximal and mid femoral and gastrocnemius veins. There is also evidence of acute partially occlusive deep vein thrombosis noted in the left common femoral and distal femoral veins. Patient was initially started on enoxaparin transitioned to apixiban for discharge.


Changed on 5/7/2021

VAERS ID: 1257659 Before After
VAERS Form:2
Age:98.0
Sex:Female
Location:New York
Vaccinated:2021-03-16
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Anticoagulant therapy

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: alendronate (FOSAMAX) 70 mg by mouth once a week furosemide (Lasix) 20 mg tablet Take 1 tablet (20 mg total) by mouth daily NIFEdipine (ADALAT CC) 30 mg ER tablet Take 1 tablet (30 mg total) by mouth daily omeprazole (PriLOSEC) 40 mg
Current Illness: NA
Preexisting Conditions: hypertension, osteoporosis
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute occlusive deep vein thrombosis noted in the left proximal and mid femoral and gastrocnemius veins. There is also evidence of acute partially occlusive deep vein thrombosis noted in the left common femoral and distal femoral veins. Patient was initially started on enoxaparin transitioned to apixiban for discharge.


Changed on 5/14/2021

VAERS ID: 1257659 Before After
VAERS Form:2
Age:98.0
Sex:Female
Location:New York
Vaccinated:2021-03-16
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Anticoagulant therapy

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: alendronate (FOSAMAX) 70 mg by mouth once a week furosemide (Lasix) 20 mg tablet Take 1 tablet (20 mg total) by mouth daily NIFEdipine (ADALAT CC) 30 mg ER tablet Take 1 tablet (30 mg total) by mouth daily omeprazole (PriLOSEC) 40 mg
Current Illness: NA
Preexisting Conditions: hypertension, osteoporosis
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute occlusive deep vein thrombosis noted in the left proximal and mid femoral and gastrocnemius veins. There is also evidence of acute partially occlusive deep vein thrombosis noted in the left common femoral and distal femoral veins. Patient was initially started on enoxaparin transitioned to apixiban for discharge.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1257659&WAYBACKHISTORY=ON


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