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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1369986



Case Details

VAERS ID: 1369986 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram thorax, Dyspnoea, Fatigue, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications: oral contraceptive, prozac
Current Illness: NA
Preexisting Conditions: NA
Allergies: Mangos
Diagnostic Lab Data: CTA Chest demonstrating PE
CDC Split Type:

Write-up: Fatigue, increasing shortness of breath for 1-2 weeks, diagnosed with pulmonary embolus on 6/2/21 in emergency department


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1369986


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