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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1263254



Case Details

VAERS ID: 1263254 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-04-07
Onset:2021-04-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis, Losartan
Current Illness: None
Preexisting Conditions: Elevated blood pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot in left calf muscle


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1263254


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