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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1395792



Case Details

VAERS ID: 1395792 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-30
Onset:2021-06-03
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Computerised tomogram abdomen, Computerised tomogram pelvis, Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anastrazole 1mg po Daily (2019) Ascorbic Acid 100mg po Daily ASA 81mg Calcium 500mg Celecoxib 200mg po BID Cholecalciferol 5,000units po Daily Cyanocobalamin 1000mcg po daily Magnesium 400mg po Daily Oxycodone-acetaminophen 5-325 Q6HPRN Ve
Current Illness:
Preexisting Conditions: Chronic Venous Insufficiency Hx Breast Cancer Hx DVT while on hormones
Allergies: No Known Drug Allergies
Diagnostic Lab Data: 06/03 Ultrasound duplex Venous right leg = acute DT of distal vein of RLE 06/09 CTA Pulm arteries and CT abdomen/pelvis with contrast - Negative for aortic aneurysm, aortic dissection or acute pulmonary embolus.
CDC Split Type:

Write-up: New/Acute DVT in right calf


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1395792


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