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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1017411

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Case Details

VAERS ID: 1017411 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: mirtazapine 30mg, valsartan 320mg, boniva 150mg, amlodipine 5mg, cyclobenzaprine 10mg, pravastatain 10mg, memantine 5mg, tramadol 50mg, ambien 5mg
Current Illness: none
Preexisting Conditions: type 2 diabetes, lumbago, depression, and insomnia
Allergies: amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient developed blood clot in her left groin one week after getting first COVID19 vaccine.

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