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Report #2892784

Received Apr 15, 2026

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
Female
Age
67 yrs
State
OH
Recovered
Unknown
Vaccinated
Oct 28, 2022
Onset
Days to onset
Hospital days

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19-2COVID19 (COVID19 (MODERNA BIVALENT))MODERNAUNK014H22AIM

Symptoms (2)

Pulmonary thrombosisThrombosis

Symptom narrative

blood clots in legs and lungs; blood clots in legs and lungs; This spontaneous case was reported by a consumer and describes the occurrence of THROMBOSIS (blood clots in legs and lungs) and PULMONARY THROMBOSIS (blood clots in legs and lungs) in an elderly female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 014H22A) for COVID-19 prophylaxis. No Medical History information was reported. On 28-Oct-2022, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular use) 1 dosage form. In 2025, the patient experienced THROMBOSIS (blood clots in legs and lungs) (seriousness criterion medically significant) and PULMONARY THROMBOSIS (blood clots in legs and lungs) (seriousness criterion medically significant). At the time of the report, THROMBOSIS (blood clots in legs and lungs) and PULMONARY THROMBOSIS (blood clots in legs and lungs) outcome was unknown. No concomitant medications provided by the reporter. It was reported that in 2025 the patient ended up with blood clots in legs and lungs for an unknown reason. The doctor informed the patient that it could have been from COVID Shot. It was unknown if the patient experienced any additional symptoms/events. No treatment medications provided by the reporter.; Reporter's Comments: The benefit-risk relationship of product is not affected by this report.