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

This is VAERS ID 1478638



Case Details

VAERS ID: 1478638 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-22
Onset:2021-07-01
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head, Computerised tomogram thorax, Electrocardiogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan of lungs and head EKG multiple blood tests
CDC Split Type:

Write-up: 2 pulmonary embolism of unknown origin


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1478638


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