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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1351020

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Case Details

VAERS ID: 1351020 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-24
Onset:2021-05-15
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram thorax abnormal, Deep vein thrombosis, Hypoxia, Pulmonary embolism, Right ventricular dysfunction, Unresponsive to stimuli
SMQs:, Cardiac failure (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone, baclofen, omeprazole, potassium chloride, pregabalin, nystatin powder, mupirocin, morphine, mesalamine, meclizine, gabapentin, ibuprofen, fludrocortisone, eszopiclone, duloxetine, diazepam, cyclobenzaprine, Vitamin D, aspiri
Current Illness: Quadrapelegic, urinary tract infections history. CVA
Preexisting Conditions: Quadrapelegic, urogenic bladder, CVA, gastric bypasxs
Allergies: Adhesive tapes
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unresponsive and unable to speak at home. Hypoxic, CT showed large bilateral pulmonary embolism with heart strain, as well as bilateral femoral DVT.


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