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

This is VAERS ID 1333699



Case Details

VAERS ID: 1333699 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Chest pain, Computerised tomogram abnormal, Dyspnoea, Echocardiogram, Electrocardiogram normal, Fibrin D dimer increased, Musculoskeletal chest pain, Painful respiration, Pulmonary embolism, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D birth control pills
Current Illness: No
Preexisting Conditions: No
Allergies: Shellfish
Diagnostic Lab Data: EKG Monday may 3 CT scan Monday May 3 D dimer Monday may 3 Heart Echo Tuesday May 4 Leg ultrasound for DVT. Tuesday May 4 Bloodwork Monday may 3 Bloodwork tuesday may 4
CDC Split Type:

Write-up: 2 days after vaccination (Sunday May 2) I began to feel slightly chest pain when I would breath on the upper left chest shooting downward to the bottom breast rib area. Every time I would take a deep breath I would feel the pain. Called loyola hotline to discuss and state worries I had. Pain continued the next day. Went to the loyola urgent care center Monday at about noon. Took EKG test there and everything seemed fine however they did mention my birth control and possible side effects. So they sent me to thenhospotal for more test. Sent me to the ER. From the ER took several test and blood work. Another eck as well as D-dimer test, lots of blood work and a CT scan. Later that night I was told I had a pulmanary embolism (blood clot in my lung) and I needed to stay overnight. They continued to take addt. Exams the next day and.more blood for test. Took a heart echo since pains were happening on my left side. As well as ultrasound on my leg to check for DVT and if more blood clots exist.. Addt. Test done that Tuesday, then was discharged Tuesday at about 5pm.


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