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

This is VAERS ID 1454652



Case Details

VAERS ID: 1454652 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort, cefepime, Synthroid, Tamsulosin, vancomycin, Tylenol, nicoderm
Current Illness: Hyponatremia, COPD, hypothyroidism, depression, pneumonia, hematuria, malnutrition, sinus tachycardia, leukocytosis, constipation, fracture, iron deficiency anemia, tobacco use disorder, osteoporosis
Preexisting Conditions: COPD, depression, hypothyroidism
Allergies: Fish containing products
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pulmonary embolism treated with heparin


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