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This is VAERS ID 1761540

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1761540
VAERS Form:2
Age:36.0
Sex:Female
Location:Colorado
Vaccinated:2021-03-19
Onset:2021-09-10
Submitted:0000-00-00
Entered:2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Ultrasound Doppler, Deep vein thrombosis

Life Threatening? No
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: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs, cephalosporins
Diagnostic Lab Data: US doppler of the lower extremity on 9/10/21
CDC 'Split Type':

Write-up: Developed a distal DVT (deep venous thrombosis) in tight leg.

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