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

This is VAERS ID 1450692



Case Details

VAERS ID: 1450692 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-06
Onset:2021-06-01
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Deep vein thrombosis, Fibrin D dimer increased, Joint range of motion decreased, Thrombosis, Ultrasound Doppler abnormal, Vaccination site pain
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (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? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Celiac Disease and Psoriatic Arthritis
Allergies: none
Diagnostic Lab Data: Blood work and Doppler scan
CDC Split Type:

Write-up: About three weeks after I received my second Pfizer vaccine, I noticed pain in my upper left arm, right at the vaccination site. Over the course of two weeks the pain intensified and got to the point that I was not able to use my left arm at all. The pain was debilitating. I contacted my primary care physician on June 17th 2021 who sent me for a D-diamer test. On Friday, June 18th, the D-diamer test was elevated so I went to the ER where they were able to do a doppler scan of my left arm. This confirmed the DVT (blood clot) in my upper left arm.


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