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

This is VAERS ID 938147



Case Details

VAERS ID: 938147 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2020-12-30
Onset:2021-01-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Full blood count, Metabolic function test, Thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Wrote down arm and up neck following vaccination with pneumonia 23 at age of 37
Other Medications: Sertraline 50mg daily
Current Illness: None
Preexisting Conditions: Albinism Prediabetes
Allergies: Shellfish Iodine Pneumonia 23 vaccine
Diagnostic Lab Data: CBC CMP vascular ultrasound
CDC Split Type:

Write-up: I am not completely convinced that this is related to the vaccine but thought I should report it just in case. I thought I had a spider bite on my left foot, and then I thought it was shingles and then cellulitis. I was then diagnosed with a blood clot today. I have never had blood clots before.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=938147

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