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This is VAERS ID 1437276

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437276
VAERS Form:2
Age:72.0
Sex:Female
Location:Ohio
Vaccinated:2021-06-30
Onset:2021-06-30
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Pulmonary embolism, Computerised tomogram thorax abnormal, Angiogram

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA 81 mg daily, DuoNeb nebulizer QID, amlodipine 5 mg daily, Ambien 10 mg QHS, Xanax 0.5 mg daily PRN, pravastatin 40 mg daily, Zoloft 100 mg daily, Lopressor 50 mg daily
Current Illness: No acute illnesses
Preexisting Conditions: Severe COPD, pulmonary fibrosis/ILD, current smoker, insomnia, HTN, dyslipidemia, CAD, sp PTCA and CABG, RLS, depression/anxiety
Allergies: NKA
Diagnostic Lab Data: Confirmed by CTA chest6/14/2021
CDC 'Split Type':

Write-up: Pulmonary embolism, with symptoms starting one week following administration of vaccine.

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