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This is VAERS ID 1262556

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1262556
VAERS Form:2
Age:49.0
Sex:Female
Location:Florida
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0411A211A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fibrin D dimer, Thrombosis

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? No
Previous Vaccinations:
Other Medications: Na
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: D-dimer test
CDC 'Split Type':

Write-up: Clotting was present


Changed on 5/7/2021

VAERS ID: 1262556 Before After
VAERS Form:2
Age:49.0
Sex:Female
Location:Florida
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0411A211A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fibrin D dimer, Thrombosis

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? No
Previous Vaccinations:
Other Medications: Na
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na Na
Diagnostic Lab Data: D-dimer test
CDC 'Split Type':

Write-up: Clotting was present


Changed on 5/14/2021

VAERS ID: 1262556 Before After
VAERS Form:2
Age:49.0
Sex:Female
Location:Florida
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0411A211A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fibrin D dimer, Thrombosis

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? No
Previous Vaccinations:
Other Medications: Na
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na Na
Diagnostic Lab Data: D-dimer test
CDC 'Split Type':

Write-up: Clotting was present

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1262556&WAYBACKHISTORY=ON


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