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

This is VAERS ID 1317002



Case Details

VAERS ID: 1317002 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none known
Preexisting Conditions: none known
Allergies: soy milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: A blood clot ( DVT)


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1317002


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