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This is VAERS ID 1346933

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1346933
VAERS Form:2
Age:55.0
Sex:Male
Location:Illinois
Vaccinated:2021-05-14
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Angiogram pulmonary abnormal, Oxygen saturation decreased, Pulmonary embolism, Ultrasound Doppler abnormal, Deep vein thrombosis, Anticoagulant therapy

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 MG tablet Take 10 mg by mouth daily aspirin EC (ASPIRIN EC) 81 MG tablet Take 81 mg by mouth daily cetirizine 10 MG tablet Take 10 mg by mouth daily cloNIDine 0.1 MG tablet Take 0.1 mg by mouth 2 (two) times daily famotidine 2
Current Illness:
Preexisting Conditions: DM type 2, obesity, hypertension
Allergies: sudafed
Diagnostic Lab Data: CTA chest showed saddle pulmonary embolism, DVT scan confirmed R popliteal DVT
CDC 'Split Type':

Write-up: Right popliteal DVT and Pulmonary embolism Needed oxygen and anticoagulation

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1346933&WAYBACKHISTORY=ON


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