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This is VAERS ID 1478638

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1478638
VAERS Form:2
Age:55.0
Sex:Female
Location:Vermont
Vaccinated:2021-05-22
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Electrocardiogram, Pulmonary embolism, Computerised tomogram thorax, Computerised tomogram head, Blood test

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan of lungs and head EKG multiple blood tests
CDC 'Split Type':

Write-up: 2 pulmonary embolism of unknown origin

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