Report #2872933

Received Nov 15, 2025

Life-threateningER / ED visitOffice visit

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Male
Age: 58 yrs
State: NV
Recovered: Recovered
Vaccinated: Jan 20, 2021
Onset: Apr 3, 2021
Days to onset: 73
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	—	IM / LA

Symptoms (2)

ThrombosisUltrasound scan

Symptom narrative

developed blood clot throughout both legs

Current illness

None

Medical history

None

Other medications

Mvi

Allergies

Tetracycline.

Lab data

ultrasound