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This is VAERS ID 1420573

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1420573
VAERS Form:2
Age:39.0
Sex:Female
Location:New York
Vaccinated:2021-06-08
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain, Chest pain, Computerised tomogram, Echocardiogram, Flank pain, Pulmonary embolism, Ultrasound Doppler, Anticoagulant therapy, Laboratory test

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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fentanyl patch, oxycodone, lunesta
Current Illness:
Preexisting Conditions: Autoimmune pancreatitis
Allergies: Penicillin, Ceclor, Biaxin, Flagyl
Diagnostic Lab Data: 6/21/21- received lab work, cat scan, echocardiogram and Doppler.
CDC 'Split Type':

Write-up: Chest pain, abdominal pain and right flank pain 12 days after vaccination. Admitted to the hospital for a pulmonary embolism 13 days after receiving vaccine and discharged the following. Prescribed blood thinner and will be following up with my doctor in a week.

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