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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1006474

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Case Details

VAERS ID: 1006474 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-01
Onset:2021-02-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chills, Computerised tomogram, Dyspnoea, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
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: Metformin, Gabapentin, Januvia, Telmisartan/HCTZ, Eliquis, Glucotrol
Current Illness: None
Preexisting Conditions: Type 2 Diabetes, Hypertension, Past Smoker (quit 2018)
Allergies: Mycin medications (Rash)
Diagnostic Lab Data: CXR: 01 Feb 2021 CT scan: 01 Feb 2021 Labs: 01 Feb 2021
CDC Split Type:

Write-up: Within 12 hrs of receiving the vaccine the pt began to experience generalized weakness, chills, shortness of breath with symptoms worsening as time went on. Pt remained afebrile. Pt presented to the ED and was diagnosed with a Pulmonary Embolism.


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