Report #2839312

Received May 2, 2025

Life-threateningHospitalizedER / ED visit

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Overview

Sex: Female
Age: 66 yrs
State: MI
Recovered: Recovered
Vaccinated: Oct 1, 2024
Onset: Oct 31, 2024
Days to onset: 30
Hospital days: 4

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	8080797	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUAD)	SEQIRUS, INC.	UNK	388494	IM / LA

Symptoms (4)

Deep vein thrombosisDyspnoeaPulmonary embolismThromboembolectomy

Symptom narrative

Patient informed after her last dose of Spikevax (10/21/2024) she experienced shortness of breath that began on 10/31/24 and resulted in her hospitalization on 11/01/24, during which she underwent a procedure to remove a saddle pulmonary embolism and received further treatment for DVT in one leg. She stated that the doctors at the hospital felt that the clot had originated in her leg.

Allergies

Penicillins and Tramadol