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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1697197



Case Details

VAERS ID: 1697197 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-30
Onset:2021-09-14
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary thrombosis
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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Wife reported getting a lung clot after getting vaccinated. Patient was hospitalized for 3 days and all three md from hospital concluded that it was caused by the vaccine.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1697197

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