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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1311528

Case Details

VAERS ID: 1311528 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Utah  
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Arthralgia, Back pain, Blood test, Chest pain, Computerised tomogram thorax abnormal, Cough, Pulmonary embolism, Ultrasound scan, X-ray
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Lutera
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ran a CT scan, X-rays and an ultra sound on Monday 5/10 as well as many blood tests
CDC Split Type:

Write-up: Pulmonary embolisms. Many clots in the lungs. Currently being treated with blood thinners. Developed a major cough and pain in my back, shoulder and chest. About 6 days of experiencing this I went to the ER and they found I had clotting in my lungs.

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