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

This is VAERS ID 1022516

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Case Details

VAERS ID: 1022516 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Hampshire  
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram abnormal, Cough, Dyspnoea, Pulmonary embolism, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pantoprazole sodium, atorvastatin calcium, fish oil, krill oil, vitamin d, vitamin b-12, fluticisone proprionate
Current Illness: none
Preexisting Conditions: elevated cholesterol, seasonal allergies
Allergies: none
Diagnostic Lab Data: 2/7/2021- admitted to ER with wheezing, coughing and severe shortness of breath, SARS-CoV2 PCR with negative results, portable chest x-ray showing lungs clear and no acute cardio-pulmonary disease. Cat scan of chest showed a pulmonary embolism in the anterior basal segment of the right lower lobe, right heart strain. blood tests were mostly in range results.
CDC Split Type:

Write-up: experienced significant shortness of breath, heavy wheezing, and coughing on the weekend of 2/6/2021. Slight wheezing had been ongoing for months (difficulty breathing in January of 2020 when diagnosed with influenza A and intermittent slight wheezing continued throughout the year). Symptoms became worse throughout the weekend. I did continue my normal routine (taking trash to the dump, helped move a heavy tank out of a walkout basement, and moving twelve 40 pound bags of wood pellets from store into truck then from truck into my home on day of hospitalization) Hospitalized on 2/7/2021

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