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

This is VAERS ID 1036912

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Case Details

VAERS ID: 1036912 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-05
Onset:2021-02-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Computerised tomogram abnormal, Injection site pain, Skin discolouration, Splenic infarction, Thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan Multiple blood tests Hospital stay of two days
CDC Split Type:

Write-up: Initial injection site pain for two days. Around day five, both armpits were discolored significantly. On day nine I was in the ER with left side abdominal cramps that was diagnosed after a CT Scan as a splenic infarction caused by a blot clot. I have not had a blot clot previously and have always been healthy with no surgeries or prescription medications except propranolol for anxiety (since the pandemic started).


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