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This is VAERS ID 1259504

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1259504
VAERS Form:2
Age:62.0
Sex:Female
Location:Wyoming
Vaccinated:2021-03-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, Chest discomfort, Dyspnoea, International normalised ratio normal, Pain in extremity, Platelet count decreased, Prothrombin time shortened, Pulmonary embolism, Rhinorrhoea, Oropharyngeal pain

Life Threatening? Yes
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:     Extended hospital stay? No
Previous Vaccinations: "shingles 2 dose series" Flu like symptoms for 2 days after. Vaccinated in < 5years ago.
Other Medications: Amlodipine 5 mg oral tab 1 tab once a day; Over the counter supplements: Cinnamon; Beet powder capsule; cranberry tablets; Kidney formula from Long-jevity
Current Illness: None
Preexisting Conditions: Hypertensive disorder; Poor kidney function; Hysterectomy; Breast lumpectomy bilateral; breast implants.
Allergies: Ibuprofen contraindicated due to her poor kidney function
Diagnostic Lab Data: 04/25/2021 @ 2312 CTA of chest with contrast w/ "Pulmonary embolism mo0re prominent on the right side. I do not see evidence of significant right heart strain. Subtle atelectasis involving the lung bases; possible infarct involving the right lung base. Saddle embolus of pulmonary artery 04/25/2021 @ PT = 10.3; INR = 0.99; PTT = 20.2. Platelets =137
CDC 'Split Type':

Write-up: 1 week post vaccine had 1 day with a sore throat and runny nose. Developed right calf pain 04/19/2021. Presented to ER on 04/25/2021 w/ a 2 day history of shortness of breath and some chest tightness worse with exertion, with worsening symptoms at time of ER visit. Admitted for observation with "Pulmonary embolism without acute cor pulmonale and Acute respiratory failure with hypoxia"


Changed on 5/7/2021

VAERS ID: 1259504 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:Wyoming
Vaccinated:2021-03-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, Chest discomfort, Dyspnoea, International normalised ratio normal, Pain in extremity, Platelet count decreased, Prothrombin time shortened, Pulmonary embolism, Rhinorrhoea, Oropharyngeal pain

Life Threatening? Yes
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:     Extended hospital stay? No
Previous Vaccinations: "shingles 2 dose series" Flu like symptoms for 2 days after. Vaccinated in < 5years ago.
Other Medications: Amlodipine 5 mg oral tab 1 tab once a day; Over the counter supplements: Cinnamon; Beet powder capsule; cranberry tablets; Kidney formula from Long-jevity
Current Illness: None
Preexisting Conditions: Hypertensive disorder; Poor kidney function; Hysterectomy; Breast lumpectomy bilateral; breast implants.
Allergies: Ibuprofen contraindicated due to her poor kidney function function
Diagnostic Lab Data: 04/25/2021 @ 2312 CTA of chest with contrast w/ "Pulmonary embolism mo0re prominent on the right side. I do not see evidence of significant right heart strain. Subtle atelectasis involving the lung bases; possible infarct involving the right lung base. Saddle embolus of pulmonary artery 04/25/2021 @ PT = 10.3; INR = 0.99; PTT = 20.2. Platelets =137
CDC 'Split Type':

Write-up: 1 week post vaccine had 1 day with a sore throat and runny nose. Developed right calf pain 04/19/2021. Presented to ER on 04/25/2021 w/ a 2 day history of shortness of breath and some chest tightness worse with exertion, with worsening symptoms at time of ER visit. Admitted for observation with "Pulmonary embolism without acute cor pulmonale and Acute respiratory failure with hypoxia"


Changed on 5/14/2021

VAERS ID: 1259504 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:Wyoming
Vaccinated:2021-03-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, Chest discomfort, Dyspnoea, International normalised ratio normal, Pain in extremity, Platelet count decreased, Prothrombin time shortened, Pulmonary embolism, Rhinorrhoea, Oropharyngeal pain

Life Threatening? Yes
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:     Extended hospital stay? No
Previous Vaccinations: "shingles 2 dose series" Flu like symptoms for 2 days after. Vaccinated in < 5years ago.
Other Medications: Amlodipine 5 mg oral tab 1 tab once a day; Over the counter supplements: Cinnamon; Beet powder capsule; cranberry tablets; Kidney formula from Long-jevity
Current Illness: None
Preexisting Conditions: Hypertensive disorder; Poor kidney function; Hysterectomy; Breast lumpectomy bilateral; breast implants.
Allergies: Ibuprofen contraindicated due to her poor kidney function function
Diagnostic Lab Data: 04/25/2021 @ 2312 CTA of chest with contrast w/ "Pulmonary embolism mo0re prominent on the right side. I do not see evidence of significant right heart strain. Subtle atelectasis involving the lung bases; possible infarct involving the right lung base. Saddle embolus of pulmonary artery 04/25/2021 @ PT = 10.3; INR = 0.99; PTT = 20.2. Platelets =137
CDC 'Split Type':

Write-up: 1 week post vaccine had 1 day with a sore throat and runny nose. Developed right calf pain 04/19/2021. Presented to ER on 04/25/2021 w/ a 2 day history of shortness of breath and some chest tightness worse with exertion, with worsening symptoms at time of ER visit. Admitted for observation with "Pulmonary embolism without acute cor pulmonale and Acute respiratory failure with hypoxia"

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