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

This is VAERS ID 956642



Case Details

VAERS ID: 956642 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-09
Onset:2021-01-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK 9231 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
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:
Other Medications: birth contol (over 10years same one ) trazadone, wellbutrin celexa
Current Illness: none
Preexisting Conditions: none
Allergies: penicillins
Diagnostic Lab Data: ultrasound 1.14.2021
CDC Split Type:

Write-up: Visited Provider appx 500 pm 1.14.2021 DVT - left calf - 2 clots via ultrasound on Eliquis now


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=956642

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