Report #2834079

Received Apr 3, 2025

Life-threateningHospitalizedER / ED visit

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Overview

Sex: Male
Age: 61 yrs
State: NV
Recovered: Recovered
Vaccinated: Mar 1, 2021
Onset: Aug 1, 2024
Days to onset: 1249
Hospital days: 4

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	045A21A	IM / RA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	020B21A	SC / LA

Symptoms (1)

Pulmonary embolism

Symptom narrative

Multiple, unprovoked pulmonary embolisms